Translational Behavioral Medicine最新文献

{"title":"Individual and clinical factors associated with patient acceptance of referrals to social services and community resources at a multi-purpose resource hub.","authors":"Gabrielle Green, Roxana Flores, Noel C Barragan, Karla Gonzalez, Tony Kuo","doi":"10.1093/tbm/ibae072","DOIUrl":"10.1093/tbm/ibae072","url":null,"abstract":"<p><p>Emerging evidence suggests that bi-directional communication and referral pathways, when employed strategically, can lead to favorable health outcomes by connecting patients with complex, multi-faceted health and social needs to appropriate services and resources. However, despite these benefits, patient acceptance of referrals via these pathways remains suboptimal. In this study, we describe individual and clinical factors associated with patient acceptance of these referrals. We extracted individual-level demographic and clinical data for patients referred primarily from a large safety-net health system to a multi-purpose resource hub co-located on the campus of its largest hospital, for the period October 2019 to June 2023. Descriptive statistics, Chi-square analyses, and multinomial regression modeling were performed to examine these data. Of 1865 patients in the study sample, 54.2% accepted a referral, 27.4% were lost to follow-up, and 18.4% declined. Most patients who accepted referrals were female (67.1%), Latino (81.5%), and had hypertension and/or prediabetes or diabetes (84.1%). In modeling analyses, those who accepted referrals tended to be female, and were referred from primary care clinics; many were referred for multiple service/resource categories. We found associations between patient acceptance of referrals and gender and source of referral. Drawing upon these results as well as experience implementing these systems, we propose several practical strategies for increasing successful referrals, including identifying and addressing barriers for patients who declined or were lost to follow-up; using standardized screening tools to routinely assess for multi-faceted health and social needs; increasing provider awareness about the benefits and functioning of these pathways; and monitoring progress so mid-course adjustments can be made when necessary.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differing conceptual maps of skills for implementing evidence-based interventions held by community-based organization practitioners and academics: A multidimensional scaling comparison.","authors":"Shoba Ramanadhan, Jennifer L Cruz, Maggie Weese, Shinelle Kirk, Madison K Rivard, Arthur Eisenkraft, Karen Peterson, Judi Kirk, Albert Whitaker, Chinyere Nwamuo, Scott R Rosas","doi":"10.1093/tbm/ibae051","DOIUrl":"10.1093/tbm/ibae051","url":null,"abstract":"<p><p>Community-based organizations (CBOs) are critical for delivering evidence-based interventions (EBIs) to address cancer inequities. However, a lack of consensus on the core skills needed for this work often hinders capacity-building strategies to support EBI implementation. The disconnect is partly due to differing views of EBIs and related skills held by those typically receiving versus developing capacity-building interventions (here, practitioners and academics, respectively). Our team of implementation scientists and practice-based advisors used group concept mapping to engage 34 CBO practitioners and 30 academics with experience addressing cervical cancer inequities implementing EBIs. We created group-specific maps of skills using multidimensional scaling and hierarchical cluster analysis, then compared them using Procrustes comparison permutations. The 98 skills were sorted into six clusters by CBO practitioners and five by academics. The groups generated maps with statistically comparable underlying structures but also statistically significant divergence. Some skill clusters had high concordance across the two maps, e.g. \"managing funding and external resources.\" Other skill clusters, e.g. \"adapting EBIs\" from the CBO practitioner map and \"selecting and adapting EBIs\" from the academic map, did not overlap as much. Across groups, key clusters of skills included connecting with community members, understanding the selected EBI and community context, adapting EBIs, building diverse and equitable partnerships, using data and evaluation, and managing funding and external resources. There is a significant opportunity to combine CBO practitioners' systems/community frames with the EBI-focused frame of academics to promote EBI utilization and address cancer and other health inequities.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing multidimensional fidelity in a pilot optimization trial: A process evaluation of four intervention components supporting medication adherence in women with breast cancer.","authors":"Sophie M C Green, Christopher D Graham, Michelle Collinson, Pei Loo Ow, Louise H Hall, David P French, Nikki Rousseau, Hollie Wilkes, Christopher Taylor, Erin Raine, Rachel Ellison, Daniel Howdon, Robbie Foy, Rebecca E A Walwyn, Jane Clark, Catherine Parbutt, Jo Waller, Jacqueline Buxton, Sally J L Moore, Galina Velikova, Amanda J Farrin, Samuel G Smith","doi":"10.1093/tbm/ibae066","DOIUrl":"10.1093/tbm/ibae066","url":null,"abstract":"<p><p>Adherence to adjuvant endocrine therapy in women with breast cancer is low. We conducted a 24-1 fractional factorial pilot optimization trial to test four intervention components supporting medication adherence [text messages, information leaflet, acceptance and commitment therapy (ACT), self-management website], in the preparation phase of the multiphase optimization strategy. Guided by the National Institute of Health Behavior Change Consortium fidelity framework, we investigated fidelity of design, training, delivery, receipt, and enactment of four intervention components. Women prescribed adjuvant endocrine therapy (n = 52) were randomized to one of eight experimental conditions comprised of combinations of the four intervention components (ISRCTN: 10487576). We assessed fidelity using self-report data (4 months post-randomization), trial data, ACT session observations, behavior change technique (BCT) coding, and interviews with participants (n = 20) and therapists (n = 6). Design: Each intervention component targeted unique behavior change techniques with some overlap. Training: All 10 therapists passed the competency assessment. Delivery: All leaflets (27/27) and website (26/26) details were sent, and ACT procedural fidelity was high (85.1%-94.3%). A median of 32.5/41 (range 11-41) text messages were delivered, but a system error prevented some messages being sent to 22 of 28 participants. Receipt: Most participants [63.0% (ACT, leaflet) to 71.4% (text messages)] read all or at least some of the intervention components they were randomized to receive. Enactment was reported most positively for ACT. All intervention components demonstrated adequate fidelity. We have provided an exemplar for assessing fidelity using the National Institute of Health Behavior Change Consortium framework in the preparation phase of multiphase optimization strategy.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaptation of meaning-centered psychotherapy for healthcare providers to buffer work-induced distress and improve wellbeing.","authors":"William E Rosa, Hayley Pessin, Jaime Gilliland, Mia R Behrens, Anessa M Foxwell, Natalie S McAndrew, Amelia E Schlak, Allison J Applebaum, Wendy G Lichtenthal, Rebecca M Saracino, William Breitbart, Kailey E Roberts","doi":"10.1093/tbm/ibae071","DOIUrl":"10.1093/tbm/ibae071","url":null,"abstract":"<p><p>Healthcare providers (HCPs) face high rates of distress, experienced as burnout, moral distress, compassion fatigue, and grief. HCPs are also experiencing a crisis in meaning whereby distress is associated with disconnection from meaning in work and, in turn, a lack of meaning in work can further perpetuate distress for HCPs. Although scalable systems-level solutions are needed to tackle multidimensional HCP distress, it is also necessary to address HCP suffering at individual, team, and institutional levels. Targeted interventions to alleviate HCP distress are limited. Meaning-centered psychotherapy (MCP), a brief, evidence-based, intervention first developed for persons with advanced cancer, holds promise to mitigate HCP distress. This study adapted MCP for HCPs through feedback from a multidisciplinary sample of clinicians trained in MCP and working in healthcare settings. A survey was distributed electronically between November and December 2023 to HCPs previously trained in MCP assessing quantitative and qualitative feedback on the appropriateness of MCP for HCPs, the relevance of MCP session topics and exercises, and implementation barriers and facilitators. Descriptive statistics on relevant participant ratings were calculated; a matrix analysis approach was used for qualitative data. Forty participants, primarily mental health providers, expressed that MCP principles were highly relevant for HCPs and offered key insights on appropriate intervention modifications, including the need for a primary focus on meaning in professional life, reduced intervention length, and delivery in group format. Feedback informed critical adjustments to promote appropriateness and acceptability of MCP-HCP which is poised for pilot testing to determine its feasibility and preliminary efficacy for HCPs.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder-informed refinement of a behavioral sleep/circadian intervention for gynecologic cancer survivors: an application of the MOST preparation phase.","authors":"Rina S Fox, Krista Brandon, Terry A Badger, Julia S Gaumond, Ana Acuña Morales, Jason C Ong, Sairam Parthasarathy, Christine Rini, Phyllis C Zee, Edward J Tanner, Sonia Ancoli-Israel, Frank J Penedo, Juned Siddique, Lisa M Wu, Kathryn J Reid, Karen Kaiser","doi":"10.1093/tbm/ibaf001","DOIUrl":"10.1093/tbm/ibaf001","url":null,"abstract":"<p><strong>Background: </strong>Sleep disturbance is among the most frequent and distressing symptoms reported by gynecologic cancer survivors. Existing evidence-based behavioral sleep interventions are limited by implementation burden, which can decrease adherence.</p><p><strong>Purpose: </strong>As part of the preparation phase of the multiphase optimization strategy (MOST), this study solicited stakeholder feedback to maximize adherence in a planned behavioral sleep/circadian intervention optimization trial.</p><p><strong>Methods: </strong>Thirteen post-treatment survivors of early-stage gynecologic cancer completed the protocol for the planned optimization trial, including simultaneous receipt of all candidate intervention components. This included six weeks of combined sleep restriction, stimulus control, and systematic exposure to morning bright light. Participants then completed a semi-structured interview to provide feedback on their experience. We used a rapid analytic approach to quickly identify actionable feedback from de-identified transcripts.</p><p><strong>Results: </strong>Participants generally reacted positively to the intervention components. Actionable feedback identified recommended protocol modifications and was categorized into four overarching themes: (i) remove barriers to engagement; (ii) revise for clarity; (iii) augment content; and (iv) consider individual circumstances.</p><p><strong>Conclusions: </strong>Rapid qualitative analysis enabled us to effectively modify our planned study protocol on an expedited timeline. This approach is consistent with the core principles of MOST and can be incorporated into the Preparation phase to enhance optimization efforts.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging artificial intelligence-mediated communication for cancer prevention and control and drug addiction: A systematic review.","authors":"Sunny Jung Kim, Viktor Clark, Jeff T Hancock, Reza Rawassizadeh, Hongfang Liu, Emmanuel A Taylor, Vanessa B Sheppard","doi":"10.1093/tbm/ibaf007","DOIUrl":"https://doi.org/10.1093/tbm/ibaf007","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a systematic review on Artificial Intelligence-Mediated Communication (AIMC) behavioral interventions in cancer prevention/control and substance use.</p><p><strong>Methods: </strong>Eight databases were searched from 2017 to 2022 using the Population Intervention Control Outcome Study (PICOS) framework. We synthesized findings of AIMC-based interventions for adult populations in cancer prevention/control or substance use, applying SIGN Methodology Checklist 2 for quality assessments and reviewing retention and engagement.</p><p><strong>Results: </strong>Initial screening identified 187 studies; seven met inclusion criteria, involving 2768 participants. Females comprised 67.6% (n = 1870). Mean participant age was 42.73 years (SD = 7.00). Five studies demonstrated significant improvements in substance use recovery, physical activity, genetic testing, or dietary habits.</p><p><strong>Conclusions: </strong>AIMC shows promise in enhancing health behaviors, but further exploration is needed on privacy risks, biases, safety concerns, chatbot features, and serving underserved populations.</p><p><strong>Implications: </strong>There is a critical need to foster comprehensive fully powered studies and collaborations between technology developers, healthcare providers, and researchers. Policymakers can facilitate the responsible integration of AIMC technologies into healthcare systems, ensuring equitable access and maximizing their impact on public health outcomes.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prescription Produce Program integrating lifestyle behavior counseling and health education: A program description and evaluation.","authors":"Kimberly Battle, Katherine Falls, Rachel Regal, Natalie Mansion, Jonathan Williams, Erin Lingo, Jered M Wendte, Leland Waters, Elizabeth Prom-Wormley, Suzanne Judd, Ana F Diallo","doi":"10.1093/tbm/ibae067","DOIUrl":"10.1093/tbm/ibae067","url":null,"abstract":"<p><p>Prescription Produce Programs (PPPs) are increasingly being used to address food insecurity and healthy diets. Yet, limited evidence exists on the effectiveness of integrating lifestyle counseling within a PPP to promote dietary and health behaviors. To describe the implementation of a 6- or 12-week PPP integrating lifestyle counseling to low-income adults. The PPP was implemented as part of a wellness and care coordination program and included: (i) a screening for social needs, (ii) PPP health education and lifestyle counseling visits, and (iii) distribution of produce. We conducted a pre- and post-descriptive analysis. We also reported a case study illustrating the PPP implementation and a Strengths/Weaknesses/Opportunities/Threats analysis. Fifty-three participants (85% Black American, 64% female, mean age: 66 years) completed the PPP. Food insecurity scores significantly decreased between pre- and post-enrollment in the PPP (P = .002). Compared with pre-enrollment, participants who completed the PPP reported an increase in the frequency of fruits and vegetables intake (χ2 = 12.6, P = .006). A majority of the participants (77%) reported setting and achieving at least one health-related goal by the end of the program. A strength of the PPP included the long-standing relationship with community partners. Weaknesses included the survey burden, the need for additional personnel, and the need for a sustained funding source. Integrating lifestyle counseling within a PPP can promote food security and a healthy diet. Future research is warranted using rigorous research methods, including randomization and a comparison group.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a community-based lifestyle intervention with initial sedentary reduction or physical activity increasing goals on self-reported health-related quality of life.","authors":"Chantele E Mitchell-Miland, Rachel G Miller, Andrea M Kriska, Ada O Youk, Tiffany L Gary-Webb, Susan M Devaraj, Thomas J Songer, Vincent C Arena, Wendy C King, Bonny Rockette-Wagner","doi":"10.1093/tbm/ibae076","DOIUrl":"https://doi.org/10.1093/tbm/ibae076","url":null,"abstract":"<p><strong>Background: </strong>In previous efforts, health-related quality of life (HRQoL) improved for individuals at high risk of type 2 diabetes and cardiovascular disease after participation in community-based lifestyle interventions (LI) with a moderate-to-vigorous physical activity (MVPA) movement goal.</p><p><strong>Purpose: </strong>It is unknown whether HRQoL improves with LI when the primary movement goal is to reduce sedentary behavior. HRQoL changes were examined among adults with overweight and prediabetes and/or metabolic syndrome randomized to a 12-month Diabetes Prevention Program-based Group Lifestyle Balance (DPP-GLB) community LI work with goals of weight-loss and either increasing MVPA (DPP-GLB) or reducing sedentary time (GLB-SED).</p><p><strong>Methods: </strong>Study participants (N = 269) completed the Euroqol 5 dimension 3 long (EQ5D-3L index and EuroQol Visual Analog Scale (EQVAS)-visual analog scale) at baseline, and 6 and 12 months. Paired t-tests were used to evaluate pre-to-post-intervention changes by arm.</p><p><strong>Results: </strong>Mean EQVAS improvements for the GLB-SED arm at 6 and 12 months were +5.6 (SE = 1.3; P < .0001) and +4.6 (SE = 1.4; P = .0006), respectively. Similar mean EQVAS improvements were reported for the DPP-GLB arm; +5.9 (SE = 1.2; P < .0001) and +4.9 (SE = 1.2; P = .0001) at 6 and 12 months, respectively. Mean EQ5D index improvements were significant in the GLB-SED arm [6 months: +0.03 (SE = 0.01; P = .004); and 12 months: +0.04 (SE = 0.01; P = .006)], but not in the DPP-GLB arm.</p><p><strong>Conclusions: </strong>Participation in community LI with a primary movement goal to reduce sedentary behavior improved HRQoL at least as well as traditional LI focused more on MVPA improvement, supporting an alternate intervention strategy for those who can't or won't engage in MVPA as the primary movement goal.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing to implement Floreciendo with Latina teens and their female caregivers: Integrating implementation science and the multiphase optimization strategy framework.","authors":"Katherine G Merrill, Jacqueline Silva, Angela Sedeño, Susana Salgado, Sara Vargas, Jennifer K Cano, Veronica Nabor, Jamison C Merrill, Jeff DeCelles, Kate Guastaferro, Ana A Baumann, Jacqueline Fuentes, Laura Rodriguez, Vanessa Melgoza, Geri R Donenberg","doi":"10.1093/tbm/ibaf005","DOIUrl":"10.1093/tbm/ibaf005","url":null,"abstract":"<p><strong>Background: </strong>Practical examples of studies integrating implementation science and the multiphase optimization strategy (MOST) framework are lacking. Floreciendo is a sexual and reproductive health program for Latina teens and their female caregivers, adapted from the IMARA evidence-based program.</p><p><strong>Purpose: </strong>We prepared for delivering Floreciendo by developing an implementation plan to support the program's adoption and sustainment.</p><p><strong>Methods: </strong>Drawing on a community-based participatory research approach, we used qualitative methods to explore program logistics, implementation determinants and strategies, adoption, and sustainability. We positioned our study activities within the preparation phases of both the MOST and the EPIS frameworks. We conducted and rapidly analyzed seven focus group discussions-one with Latina teens (n = 9), one with female caregivers (n = 6), four with organizational staff (n = 32), and one with IMARA staff (n = 6)-and seven key informant interviews.</p><p><strong>Results: </strong>Participants described community organizations as the preferred location for workshops in offering a \"safe space.\" They recommended workshop delivery on two days over separate weekends. Teens and caregivers requested relatable, bilingual Latina facilitators. Implementation barriers were raised (e.g. work conflicts) with strategies to address them (e.g. provide stipends). Organizational adoption was perceived as likely since the workshop addresses clients' needs and fits with organizational values. Recommendations for sustainment included identifying funding opportunities specific to each organization.</p><p><strong>Conclusions: </strong>Findings directly informed our immediate plans to optimize Floreciendo using the MOST framework and principles and our long-term goals for adoption and sustainability. Implementation science can strengthen studies using the MOST framework.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"15 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11886812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel factors influence the use of a cardiovascular disease assessment tool embedded in the electronic health record in oncology care.","authors":"Maura M Kepper, Raúl D Gierbolini-Rivera, Kathryn E Weaver, Randi E Foraker, Emily V Dressler, Chandylen L Nightingale, Aylin A Aguilar, Kimberly D Wiseman, Jenny Hanna, Alyssa D Throckmorton, Simon Craddock Lee","doi":"10.1093/tbm/ibae058","DOIUrl":"10.1093/tbm/ibae058","url":null,"abstract":"<p><p>Digital health tools are positive for delivering evidence-based care. However, few studies have applied rigorous frameworks to understand their use in community settings. This study aimed to identify implementation determinants of the Automated Heart-Health Assessment (AH-HA) tool within outpatient oncology settings as part of a hybrid effectiveness-implementation trial. A mixed-methods approach informed by the Consolidated Framework for Implementation Research (CFIR) examined barriers and facilitators to AH-HA implementation in four NCI Community Oncology Research Program (NCORP) practices participating in the WF-1804CD AH-HA trial. Provider surveys were analyzed using descriptive statistics. Interviews with providers (n = 15) were coded using deductive (CFIR) and inductive codes by trained analysts. The CFIR rating tool was used to rate each quote for (i) valence, defined as a positive (+) or negative (-) influence, and (ii) strength, defined as a neutral (0), weak (1), or strong (2) influence on implementation. All providers considered discussing cardiovascular health with patients as important (61.5%, n = 8/13) or somewhat important (38.5%, n = 5/13). The tool was well-received by providers and was feasible to use in routine care among cancer survivors. Providers felt the tool was acceptable and usable, had a relative advantage over routine care, and had the potential to generate benefits for patients. Common reasons clinicians reported not using AH-HA were (i) insufficient time and (ii) the tool interfering with workflow. Systematically identifying implementation determinants from this study will guide the broader dissemination of the AH-HA tool across clinical settings and inform implementation strategies for future scale-up hybrid trials.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}