Verbunt Ebony, Boyd Lucy, Creagh Nicola, Milley Kristi, Emery Jon, Nightingale Claire, Kelaher Margaret
Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria.
Centre for Cancer Research, Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria.
Aust N Z J Public Health. 2022 Dec;46(6):858-864. doi: 10.1111/1753-6405.13272. Epub 2022 Jun 23.
This study aimed to explore factors across the environment, organisation and care team levels of the health care system that influence the engagement of primary healthcare workers (PHCWs) in Australia's national cancer screening programs.
A cross-sectional qualitative study involving semi-structured interviews with PHCWs - general practitioners (n=10), practices nurses (n=10), and practice managers (n=10) from settings across Australia. Transcripts were analysed using the Framework Method.
Two environment-level factors were found to influence several organisation and care team level factors. Firstly, the financial structure of primary health care, impacting on practitioner: time, practice culture, screening knowledge and opportunistic conversations. Secondly, the structure of screening programs had flow-on effects for: access to patient screening records, recall and reminder systems, and sense of program ownership.
Encouraging more effective PHCW engagement in the screening programs requires the consideration and mitigation of overarching financial and structural barriers. Up-to-date and easy-to-use recall and reminder systems, whole-of-practice approaches which optimise the role of each PHCW and the identification of a 'champion' to drive implementation should be considered.
This study offers insights into what elements practice and practitioner targeted initiatives in Australia should incorporate, potentially leading to improved engagement of PHCWs and increased cancer screening participation rates.
本研究旨在探讨医疗保健系统中环境、组织和护理团队层面的因素，这些因素会影响澳大利亚国家癌症筛查项目中初级医疗保健工作者（PHCWs）的参与度。
一项横断面定性研究，对澳大利亚各地的PHCWs（全科医生10名、执业护士10名和执业经理10名）进行半结构化访谈。使用框架法对访谈记录进行分析。
发现两个环境层面的因素会影响几个组织和护理团队层面的因素。首先，初级医疗保健的财务结构，对从业者的时间、执业文化、筛查知识和机会性对话产生影响。其次，筛查项目的结构对获取患者筛查记录、召回和提醒系统以及项目主人翁意识产生连锁反应。
鼓励PHCWs更有效地参与筛查项目需要考虑并减轻总体财务和结构障碍。应考虑采用最新且易于使用的召回和提醒系统、优化每位PHCW角色的全执业方法以及确定推动实施的“倡导者”。
本研究为澳大利亚针对实践和从业者的举措应纳入哪些要素提供了见解，可能会提高PHCWs的参与度并提高癌症筛查参与率。
