Lung cancer screening in rural primary care practices in Colorado: time for a more team-based approach?
Background: Despite lung cancer being a leading cause of death in the United States and lung cancer screening (LCS) being a recommended service, many patients eligible for screening do not receive it. Research is needed to understand the challenges with implementing LCS in different settings. This s...
| Publicado en: | BMC Primary Care Vol. 24; no. 1; pp. 1 - 15 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
BioMed Central
3/3/2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=162234006&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 162234006 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27314553 MZZU jtl: BMC Primary Care issn: 27314553 maglogo: N pubinfo: dt: 3/3/2023 vid: 24 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 162234006 162234006 162234006 10.1186/s12875-023-02003-x 162234006 ppf: 1 ppct: 14 formats: tig: atl: Lung cancer screening in rural primary care practices in Colorado: time for a more team-based approach? aug: au: Gomes, Rebekah Nederveld, Andrea Glasgow, Russell E. Studts, Jamie L. Holtrop, Jodi Summers affil: University of Colorado Adult & Child Center for Outcomes Research & Delivery Science (ACCORDS), Aurora, CO, USA sug: subj: Lung Neoplasms Colorado Cancer Screening Primary Health Care Rural Areas Patient Attitudes Medical Practice Teamwork Human Male Female Middle Age Aged Colorado Qualitative Studies Semi-Structured Interview Thematic Analysis Implementation Science Conceptual Framework Early Detection of Cancer Funding Source Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Despite lung cancer being a leading cause of death in the United States and lung cancer screening (LCS) being a recommended service, many patients eligible for screening do not receive it. Research is needed to understand the challenges with implementing LCS in different settings. This study investigated multiple practice members and patient perspectives impacting rural primary care practices related to LCS uptake by eligible patients. Methods: This qualitative study involved primary care practice members in multiple roles (clinicians n = 9, clinical staff n = 12 and administrators n = 5) and their patients (n = 19) from 9 practices including federally qualified and rural health centers (n = 3), health system owned (n = 4) and private practices (n = 2). Interviews were conducted regarding the importance of and ability to complete the steps that may result in a patient receiving LCS. Data were analyzed using a thematic analysis with immersion crystallization then organized using the RE-AIM implementation science framework to illuminate and organize implementation issues. Results: Although all groups endorsed the importance of LCS, all also struggled with implementation challenges. Since assessing smoking history is part of the process to identify eligibility for LCS, we asked about these processes. We found that smoking assessment and assistance (including referral to services) were routine in the practices, but other steps in the LCS portion of determining eligibility and offering LCS were not. Lack of knowledge about screening and coverage, patient stigma, and resistance and practical considerations such as distance to LCS testing facilities complicated completion of LCS compared to screening for other types of cancer. Conclusions: Limited uptake of LCS results from a range of multiple interacting factors that cumulatively affect consistency and quality of implementation at the practice level. Future research should consider team-based approaches to conduct of LCS eligibility and shared decision making. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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