A study protocol for a mixed-method environmental scan of contextual factors that influence lung cancer screening adherence.

Erin A Hirsch, Joelle Fathi, Andrew Ciupek, Lisa Carter-Bawa
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引用次数: 0

Abstract

Background: The efficacy of lung cancer screening (LCS) to reduce lung cancer specific mortality is heavily dependent on adherence to recommended screening guidelines, with real-world adherence rates reported to be drastically lower than rates described in clinical trials. There is a dearth in the literature on reminder processes and clinical workflows used to address adherence and robust data is needed to fully understand which clinical set-ups, processes, and context enhance and increase continued LCS participation. This paper describes a protocol for an environmental scan of adherence and reminder processes that are currently used in LCS programs across the United States.

Methods: This study will triangulate data using a 3-step explanatory sequential mixed methods design to describe mechanisms of current adherence and reminder systems within academic and community LCS programs to pinpoint clinic or system barrier and facilitator combinations that contribute to increased adherence. In step 1, surveys from a nationally representative sample of LCS programs will yield quantitative data about program structure, volume, and tracking/reminder processes and messages. After completion of the survey, interested LCS program personnel will be invited to participate in an in-depth interview (step 2) to explore current processes and interventions used for adherence at the participant and program level. Finally, in step 3, triangulation of quantitative and qualitative data will be completed through qualitative comparative analysis to identify combinations of components that affect higher or lower adherence.

Discussion: This research advances the state of the science by filling a gap in knowledge about LCS program characteristics and processes associated with better adherence which can inform the development and implementation of interventions that are scalable and sustainable across a wide variety of clinical practice settings.

采用混合方法对影响肺癌筛查依从性的环境因素进行环境扫描的研究方案。
背景:肺癌筛查(LCS)降低肺癌特定死亡率的效果在很大程度上取决于对推荐筛查指南的依从性,据报道,现实世界中的依从率远远低于临床试验中描述的比率。有关用于解决依从性问题的提醒流程和临床工作流程的文献十分匮乏,因此需要可靠的数据来充分了解哪些临床设置、流程和环境可以提高和增加肺癌筛查的持续参与率。本文介绍了对美国各地 LCS 项目中目前使用的依从性和提醒流程进行环境扫描的方案:本研究将采用三步解释性顺序混合方法设计对数据进行三角测量,以描述当前学术和社区 LCS 项目中的依从性和提醒系统机制,从而找出有助于提高依从性的诊所或系统障碍和促进因素组合。第一步,对具有全国代表性的长期护理服务项目进行抽样调查,获得有关项目结构、数量、跟踪/提醒流程和信息的定量数据。调查完成后,将邀请感兴趣的 LCS 项目人员参加深度访谈(第 2 步),以探讨目前在参与者和项目层面上用于坚持治疗的流程和干预措施。最后,在第三步中,将通过定性比较分析完成定量和定性数据的三角测量,以确定影响坚持率高低的因素组合:这项研究填补了有关提高依从性的长期护理计划特征和过程的知识空白,为开发和实施可在各种临床实践环境中推广和持续的干预措施提供了信息,从而推动了科学研究的发展。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
0.00%
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审稿时长
24 weeks
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