在俄克拉荷马州农村地区实施部落参与的肺癌筛查试点计划。

Zsolt Nagykaldi, Mark Doescher, Dorothy A Rhoades, Kathleen Dwyer, Ann Chou, Michele Gibson
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引用次数: 0

摘要

部落参与的肺癌筛查方法(TEALS)研究旨在共同设计和测试一个大型部落运营的卫生系统中基于社区的肺癌筛查(LCS)项目。2020-2021年,我们在俄克拉何马州农村的两个乔克托族(Choctaw Nation of Oklahoma, CNO)初级保健诊所进行了一项量身定制的综合LCS计划的准实验前试点实施研究。该计划包括筛查质量评估、学术细节、实践促进、卫生系统改进、技术支持、集中LCS协调和社区外展。LCS的资格是基于2013年美国预防服务工作组指南。参与者完成了干预前和干预后关于LCS的知识、态度和经验的调查。提取所有参与者的图表以确定LCS完成情况。实施后对患者和临床医生进行了半结构化访谈,并分析了实践促进者的笔记。参与者(N=57)平均年龄为67岁,其中66%为当前吸烟者。更新LCS的参与者比例从39%增加到58% (p
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementing a Tribally-Engaged Lung Cancer Screening Pilot Program in Rural Oklahoma.

The Tribally-Engaged Approaches to Lung Cancer Screening (TEALS) study aimed to co-design and test a community-based lung cancer screening (LCS) program within a large, tribally operated health system. In 2020-2021, we conducted a pre-post quasi-experimental pilot implementation study of a tailored and comprehensive LCS program in two Choctaw Nation of Oklahoma (CNO) primary care clinics in rural Oklahoma. The program included screening quality assessment, academic detailing, practice facilitation, health system enhancements, technology support, centralized LCS coordination, and community outreach. Eligibility for LCS was based on the 2013 US Preventive Services Task Force guidelines. Participants completed pre- and post-intervention surveys on their knowledge, attitudes, and experiences regarding LCS. All participant charts were extracted to determine LCS completion. Post-implementation semi-structured interviews of patients and clinicians were conducted and practice facilitator notes were analyzed. Participants (N=57) averaged 67 years, and 66% were current smokers. The proportion of participants who were up to date with LCS increased from 39% to 58% (p<0.01). About 18% of patients reported improvement in general care choice and treatment discussions with their doctor and about 40% reported an improvement in their awareness or understanding of lung cancer and receipt of LCS. We also identified several key facilitators and barriers to LCS implementation at the practice and health system levels. LCS acceptance and uptake improved significantly in this community-engaged pilot intervention which informed a subsequent cluster-randomized trial. Comprehensive and community-engaged LCS programs may have the potential to improve the delivery of LCS in underserved community settings.

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