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使其发挥作用:医疗服务提供者对在联邦合格医疗中心增加结直肠癌筛查策略的看法。

Making it work: health care provider perspectives on strategies to increase colorectal cancer screening in federally qualified health centers.

作者信息

Gwede Clement K, Davis Stacy N, Quinn Gwendolyn P, Koskan Alexis M, Ealey Jamila, Abdulla Rania, Vadaparampil Susan T, Elliott Gloria, Lopez Diana, Shibata David, Roetzheim Richard G, Meade Cathy D

机构信息

Division of Cancer Prevention and Control, Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL, 33612, USA,

出版信息

J Cancer Educ. 2013 Dec;28(4):777-83. doi: 10.1007/s13187-013-0531-8.

Abstract

Colorectal cancer screening (CRCS) rates are low among men and women who seek health care at federally qualified health centers (FQHCs). This study explores health care providers' perspectives about their patient's motivators and impediments to CRCS and receptivity to preparatory education. A mixed methods design consisting of in-depth interviews, focus groups, and a short survey is used in this study. The participants of this study are 17 health care providers practicing in FQHCs in the Tampa Bay area. Test-specific patient impediments and motivations were identified including fear of abnormal findings, importance of offering less invasive fecal occult blood tests, and need for patient-centered test-specific educational materials in clinics. Opportunities to improve provider practices were identified including providers' reliance on patients' report of symptoms as a cue to recommend CRCS and overemphasis of clinic-based guaiac stool tests. This study adds to the literature on CRCS test-specific motivators and impediments. Providers offered unique approaches for motivating patients to follow through with recommended CRCS and were receptive to in-clinic patient education. Findings readily inform the design of educational materials and interventions to increase CRCS in FQHCs.

摘要

在联邦合格医疗中心(FQHC)寻求医疗服务的男性和女性中,结直肠癌筛查(CRCS)率较低。本研究探讨了医疗服务提供者对其患者进行CRCS的动机、障碍以及对预备教育的接受程度的看法。本研究采用了一种混合方法设计,包括深入访谈、焦点小组和简短调查。本研究的参与者是在坦帕湾地区FQHC执业的17名医疗服务提供者。确定了特定检测的患者障碍和动机,包括对异常结果的恐惧、提供侵入性较小的粪便潜血检测的重要性以及诊所中对以患者为中心的特定检测教育材料的需求。确定了改善医疗服务提供者做法的机会,包括医疗服务提供者依赖患者的症状报告作为推荐CRCS的线索以及对基于诊所的愈创木脂粪便检测的过度强调。本研究为关于CRCS特定检测动机和障碍的文献增添了内容。医疗服务提供者提供了激励患者完成推荐的CRCS的独特方法,并接受诊所内的患者教育。研究结果为设计教育材料和干预措施以提高FQHC中的CRCS提供了依据。

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