Advancing health equity: A qualitative study assessing barriers and facilitators of implementing hereditary breast and ovarian cancer risk screening tools in community‐based organizations.

Genetic counseling and testing (GCT) inform cancer management for persons at risk for hereditary breast and ovarian cancer (HBOC). Community‐based organizations (CBOs) may play a role in identifying at‐risk Latinx individuals to connect them to GCT but data are lacking. Two academic centers and thei...

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Publicado en:Journal of Genetic Counseling Vol. 32; no. 5; pp. 965 - 982
Autores principales: Bowen, Alexandra, Gómez‐Trillos, Sara, Curran, Geoffrey, Graves, Kristi D., Sheppard, Vanessa B., Schwartz, Marc D., Peshkin, Beth N., Campos, Claudia, Garcés, Nathaly, Dash, Chiranjeev, Aburto, Luisa, Valencia‐Rojas, Nancy, Hernández, Gina, Villa, Antonio, Cupertino, Paula, Carrera, Pilar, Hurtado‐de‐Mendoza, Alejandra
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2023
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2023
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Advancing health equity: A qualitative study assessing barriers and facilitators of implementing hereditary breast and ovarian cancer risk screening tools in community‐based organizations.
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          Bowen, Alexandra
          Gómez‐Trillos, Sara
          Curran, Geoffrey
          Graves, Kristi D.
          Sheppard, Vanessa B.
          Schwartz, Marc D.
          Peshkin, Beth N.
          Campos, Claudia
          Garcés, Nathaly
          Dash, Chiranjeev
          Aburto, Luisa
          Valencia‐Rojas, Nancy
          Hernández, Gina
          Villa, Antonio
          Cupertino, Paula
          Carrera, Pilar
          Hurtado‐de‐Mendoza, Alejandra
        affil: Rutgers University, New Brunswick New Jersey,, USA
      sug:
        subj:
          Health Inequities
          Health Services Accessibility
          Breast Neoplasms Diagnosis
          Ovarian Neoplasms Diagnosis
          Cancer Screening
          Early Detection of Cancer Methods
          Cancer Patients
          Ovarian Neoplasms Familial and Genetic
          Breast Neoplasms Familial and Genetic
          Human
          Female
          Adult
          Middle Age
          Aged
          Qualitative Studies
          Conceptual Framework
          Genetic Counseling
          Genetic Screening
          Focus Groups
          Risk Assessment
          Nursing Staff, Hospital
          Program Implementation Evaluation
          Implementation Science
          Guideline Adherence
          Organizational Culture
          Descriptive Statistics
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Female
      ab: Genetic counseling and testing (GCT) inform cancer management for persons at risk for hereditary breast and ovarian cancer (HBOC). Community‐based organizations (CBOs) may play a role in identifying at‐risk Latinx individuals to connect them to GCT but data are lacking. Two academic centers and their four CBO partners planned to implement a validated questionnaire for HBOC risk screening ("HBOC risk screening tool"). This study aimed to assess CBO's preferences for HBOC risk screening tools, as well as the barriers and facilitators anticipated for future implementation. Pre‐implementation focus groups were conducted with CBO's staff. Discussions centered on current practices to identify and refer at‐risk patients. During the discussion, staff were asked to select one out of five validated HBOC risk screening tools to implement and to discuss anticipated barriers/facilitators for implementation. The four focus groups were coded and qualitative analyzed following the Consolidated Framework for Implementation Research (CFIR) and Health Equity domains. All CBOs chose the Family History Screen 7 (FHS‐7). Participants (N = 35) highlighted how the FHS‐7 was easy to adapt to better fit the target population and changing guidelines. They had positive attitudes toward implementing the screening tool, stressed how the culture of the organization positioned them to reach the target population, and noted barriers in different CFIR domains (e.g., low knowledge about HBOC and GCT referrals; scarce available resources). Participants pointed to barriers related to health equity domains including limited access to GCT and follow‐up care for uninsured and underinsured populations, challenges obtaining accurate family history, and immigration‐related barriers. CBOs highlighted the importance of partnering with other stakeholders to overcome barriers. Findings emphasize the need to develop multi‐level implementation strategies to overcome barriers and leverage facilitators. This study can inform the development of implementation toolkits for CBOs to implement HBOC screening tools to advance health equity.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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