为基层医疗机构的结直肠癌筛查调整远程交付的患者导航计划:农村地区的重要考虑因素。

IF 3 Q1 PRIMARY HEALTH CARE
Brooke Ike, Gina A Keppel, Katie P Osterhage, Linda K Ko, Allison Cole
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引用次数: 0

摘要

简介:结肠镜检查是结肠直肠癌(CRC)筛查的重要组成部分,患者导航(PN)可提高结肠镜检查的完成率。在农村初级医疗机构(PCOs)中远程提供导航的非专业导航员可以提高患者接受结肠镜检查的机会。为准备农村社区结肠镜检查推广(CORC)研究,我们考察了合作伙伴对可能影响 CORC 计划实施的背景因素的看法,以及为减少潜在障碍而进行的调整:我们采访了来自 6 个合作 PCO 和实施 PN 计划的社区组织 (CBO) 的 29 位人士。根据 Miles、Huberman 和 Saldana 的分析方法确定了关键主题。结果采用 "报告适应性和修改性增强框架"(FRAME)进行报告:潜在的障碍包括:农村患者很难通过远程接触到导航员,可能会对导航员产生不信任;社区组织不熟悉患者社区,没有患者护理经验,也没有与 PCO 之间预先存在的沟通途径。我们对项目内容和导航员培训进行了调整,以减轻这些挑战:我们的研究强调了在实施服务于农村社区的远程、集中式患者导航计划之前需要考虑的背景因素。通过收集合作伙伴的观点,我们对干预措施进行了调整,旨在解决潜在的障碍,同时保留循证干预措施的核心内容。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adapting a Remotely Delivered Patient Navigation Program for Colorectal Cancer Screening in Primary Care: Important Considerations for Rural Contexts.

Introduction: Colonoscopy is a critical component of colorectal cancer (CRC) screening and patient navigation (PN) improves colonoscopy completion. A lay navigator remotely providing navigation across rural primary care organizations (PCOs) could increase PN access. In preparation for the Colonoscopy Outreach for Rural Communities (CORC) study, we examined partners' perspectives on contextual factors that could influence CORC program implementation, and adaptations to mitigate potential barriers.

Methods: We interviewed 29 individuals from 6 partner PCOs and the community-based organization (CBO) delivering the PN program. An analysis approach informed by Miles, Huberman, and Saldana identified critical themes. Results are reported using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME).

Results: Potential barriers included that rural patients are hard to reach remotely and might mistrust the navigator, and the CBO is unfamiliar with the patient communities and does not have patient care experience or pre-existing communication pathways with the PCOs. Program content and navigator training was adapted to mitigate these challenges.

Conclusions: Our study highlights contextual factors to account for before implementing a remote, centralized patient navigation program serving rural communities. Gathering partner perspectives led to intervention adaptations intended to address potential barriers while leaving the core components of the evidence-based intervention intact.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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