Barriers to Implementation of Breast Cancer Risk Assessment: The Health Care Team Perspective

被引:7
|
作者
Spalluto, Lucy B. [1 ,2 ,3 ,4 ,5 ]
Bonnet, Kemberlee [6 ]
Sonubi, Chiamaka [7 ]
Ernst., Laura L. [8 ]
Wahab., Rifat [9 ]
Reid, Sonya A. [3 ,10 ]
Agrawal, Pooja. [11 ]
Gregory, Kris [12 ]
Davis, Katie M. [13 ]
Lewis, Jennifer A. [3 ,10 ,14 ]
Berardi, Elizabeth [15 ]
Hartsfield, Crissy [16 ]
Selove, Rebecca [3 ,17 ]
Sanderson, Maureen [3 ,18 ]
Schlundt, David [6 ]
Audet, Carolyn M. [19 ,20 ,21 ]
机构
[1] Vanderbilt Univ, Med Ctr, Hlth Equ, Dept Radiol, Nashville, TN USA
[2] Vanderbilt Univ, Med Ctr, Divers & Inclus, Dept Radiol, Nashville, TN USA
[3] Vanderbilt Ingram Canc Ctr, Nashville, TN USA
[4] Vet Hlth Adm Tennessee Valley Hlth Care Syst, Geriatr Res Educ & Clin Ctr GRECC, Nashville, TN USA
[5] Hlth Equ Committee, Nashville, TN USA
[6] Vanderbilt Univ, Dept Psychol, Nashville, TN USA
[7] Emory Univ, Dept Rehabil Med, Sch Med, Atlanta, GA USA
[8] Vanderbilt Univ, Sch Med, Nashville, TN USA
[9] Univ Cincinnati, Dept Radiol, Cincinnati, OH USA
[10] Vanderbilt Univ, Div Hematol & Oncol, Med Ctr, Nashville, TN USA
[11] Univ Texas Med Branch, John Sealy Sch Med, Galveston, TX USA
[12] Univ Arizona, R Ken Coit Coll Pharm, Tucson, AZ USA
[13] Vanderbilt Univ, Med Ctr, Dept Radiol, Breast Imaging, Nashville, TN USA
[14] Vet Hlth Adm Tennessee Valley Hlth Care Syst, Clin Lung Screening Program, Geriatr Res Educ & Clin Ctr GRECC, Nashville, TN USA
[15] Tennessee Dept Hlth, Tennessee Breast & Cerv Screening Program, Nashville, TN USA
[16] Tennessee Dept Hlth, Div Family Hlth & Wellness, Nashville, TN USA
[17] Tennessee Dept Hlth, Ctr Prevent Res, Nashville, TN USA
[18] Meharry Med Coll, Dept Family & Community Med, Nashville, TN USA
[19] Vanderbilt Univ, Dept Hlth Policy, Med Ctr, Nashville, TN USA
[20] Vanderbilt Ctr Clin Qual & Implementat Res, Nashville, TN USA
[21] Vanderbilt Inst Global Hlth, Res, Nashville, TN USA
关键词
Breast cancer; implementation science; mammography; risk assessment; HIGH FAMILIAL RISK; MAMMOGRAPHY; WOMEN; DISPARITIES; PREVENTION; MORTALITY; MODEL;
D O I
10.1016/j.jacr.2022.12.019
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Purpose: To assess health care professionals' perceptions of barriers to the utilization of breast cancer risk assessment tools in the public health setting through a series of one-on-one interviews with health care team members.Methods: We conducted a cross-sectional qualitative study consisting of one-on-one semistructured telephone interviews with health care team members in the public health setting in the state of Tennessee between May 2020 and October 2020. An iterative inductive-deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual framework to depict influences of provider behavior in the utilization of breast cancer risk assessment.Results: A total of 24 interviews were completed, and a framework of influences of provider behavior in the utilization of breast cancer risk assessment was developed. Participants identified barriers to the utilization of breast cancer risk assessment (knowledge and un-derstanding of risk assessment tools, workflow challenges, and availability of personnel); patient-level barriers as perceived by health care team members (psychological, economic, educational, and environmental); and strategies to increase the utilization of breast cancer risk assessment at the provider level (leadership buy-in, training, supportive policies, and incentives) and patient level (improved commu-nication and better understanding of patients' perceived cancer risk and severity of cancer).Conclusions: Understanding barriers to implementation of breast cancer risk assessment and strategies to overcome these barriers as perceived by health care team members offers an opportunity to improve implementation of risk assessment and to identify a racially, geographically, and socioeconomically diverse population of young women at high risk for breast cancer.
引用
收藏
页码:342 / 351
页数:10
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