Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, 3D10T2N 4Z6, Canada.
Provincial Seniors Health and Continuing Care, Alberta Health Services, 10301 Southport Lane SW, Calgary, AB, T2W 1S7, Canada.
Arch Osteoporos. 2021 Sep 17;16(1):136. doi: 10.1007/s11657-021-00994-7.
Catch a Break staff conducting the organizational work of delivering secondary fracture prevention screening conversations drew on cultural and organizational resources to determine eligibility of individuals. They encountered and navigated their way through interactional troubles as they requested participation, assessed trauma risk, and provided lifestyle information.
We investigated delivery of a population-based type C fracture liaison service for non-hip fractures. The purpose of this study was to examine accounts of how osteoporosis health risk screening interactions were delivered.
A pre-determined sample of 5 organizational representatives (program staff) were interviewed by telephone. We analyzed the qualitative data through the lens of interpretive inquiry, informed by discourse analysis, to examine staff's "talk" about conducting the program risk screening conversations.
A dominant finding emerging from CAB staff's accounts of program delivery was the conversational work required to include only those individuals deemed appropriate for the program while managing the survey interaction. Staff talked about specific examples of interactional troubles they experienced as barriers to the smooth and successful risk screening conversation. They drew on cultural and organizational resources as interpretive frameworks to make decisions about individuals and groups at risk and in need of further investigation. They drew on larger ideas about ageism and genderism, judging as inappropriate for participation the oldest old adults, men involved in high risk occupations, and adults aged 50 to 70. Staff also employed interactional resources useful in managing problems in the conversation during the request to participate, trauma risk assessment, and lifestyle/health information provision sequences of the risk screening call.
We uncovered areas in the screening interaction that were talked about by staff as problematic to achieving the program objective of identifying and enrolling individuals in the secondary fracture prevention program. By highlighting areas for improvement in program delivery, this study may help to reduce the interactional troubles staff negotiate as they deliver this type of program.
开展二级骨折预防筛查对话的组织工作的工作人员利用文化和组织资源来确定个人的资格。他们在请求参与、评估创伤风险和提供生活方式信息时遇到并解决了互动中的问题。
我们调查了为非髋部骨折提供基于人群的 C 型骨折联络服务的情况。本研究的目的是研究如何提供骨质疏松症健康风险筛查互动的报告。
通过电话对 5 名组织代表（项目工作人员）进行了预定样本的访谈。我们通过解释性探究的视角分析定性数据，受话语分析的启发，以检查工作人员进行计划风险筛查对话的“谈话”。
CAB 工作人员对项目交付情况的叙述中出现的一个主要发现是，在管理调查互动的同时，需要进行对话工作，只包括那些被认为适合该项目的人。工作人员谈到了他们在进行风险筛查对话时遇到的互动障碍的具体例子。他们利用文化和组织资源作为解释框架，对处于风险中的个人和群体做出决策，并需要进一步调查。他们还利用关于年龄歧视和性别歧视的更大观念，认为最年长的老年人、从事高风险职业的男性以及 50 至 70 岁的成年人不适合参与。工作人员还在请求参与、创伤风险评估和生活方式/健康信息提供的风险筛查电话序列中，利用了在对话中管理问题的互动资源。
我们发现了工作人员在筛查互动中提到的有问题的领域，这些问题会影响到识别和招募个人参加二级骨折预防计划的项目目标的实现。通过强调在项目交付方面需要改进的领域，本研究可能有助于减少工作人员在提供这种类型的项目时所协商的互动问题。
