Bednar Erica M, Nitecki Wilke Roni, Jorgensen Kirsten, Walsh Michael T, Nutt Stephanie, Lu Karen H, Nóbrega Leandro, De Souza Aline Patricia Soares Dias, da Silva Oliveira Gabriela, da Cunha Andrade Carlos Eduardo Mattos, Purizaca-Rosillo Nelson, Mora Pamela, López Blanco Aldo, Gallardo-Alvarado Lenny N, Cantú-de León David, Rauh-Hain J Alejandro
Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Clinical Cancer Genetics, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Community Genet. 2024 Dec;15(6):681-686. doi: 10.1007/s12687-024-00744-5. Epub 2024 Oct 14.
Clinical cancer genetics services are expanding globally, but national policy and health care systems influence availability and implementation. Understanding the environmental factors within a country is required to appropriately implement, adapt, and evaluate cancer genetics service delivery models. An environmental scan (ES) is an approach used in business, public health, health care and other sectors to collect information about an environment or system for strategic decision making and program planning. An ES has been previously used to assess cancer genetics clinic-level factors to inform quality improvement efforts in the United States. We assessed the feasibility of using an ES to collect information about factors that may influence cancer genetics service delivery in the outer-most socio-ecological model environmental levels (policy, national agencies, healthcare systems, cultural considerations) in three Latin American countries.
Oncology and Genetics care team members at three participating sites used publicly available sources and personal experiences to complete a data collection form (DCF) that included questions about subtopics: laws and policies, relevant agencies and regulations, health care systems and insurance, and cultural considerations. Time to complete the DCF and DCF completeness were used to measure ES feasibility.
Participating sites completed the DCF in 3 months, and most questions (average, 87.0%) were answered. Questions in the cultural considerations subtopic had the fewest answers (average, 77.8%).
Overall, the ES was feasible and identified a lack of published literature related to cultural considerations impacting health care and genetics services uptake in Latin America. Environmental factors impact cancer genetics services, and identification of these factors will facilitate future collaborative research and genetics service delivery dissemination efforts.
临床癌症遗传学服务正在全球范围内扩展，但国家政策和医疗保健系统会影响其可及性和实施情况。要恰当地实施、调整和评估癌症遗传学服务提供模式，就需要了解一个国家内部的环境因素。环境扫描（ES）是一种在商业、公共卫生、医疗保健及其他领域中使用的方法，用于收集有关环境或系统的信息，以进行战略决策和项目规划。此前，环境扫描已被用于评估美国癌症遗传学诊所层面的因素，以为质量改进工作提供信息。我们评估了在三个拉丁美洲国家，使用环境扫描来收集有关可能影响最外层社会生态模型环境层面（政策、国家机构、医疗保健系统、文化因素）癌症遗传学服务提供的因素的信息的可行性。
三个参与地点的肿瘤学和遗传学护理团队成员利用公开可用资源和个人经验，完成一份数据收集表（DCF），其中包括关于子主题的问题：法律和政策、相关机构和法规、医疗保健系统和保险，以及文化因素。完成数据收集表的时间和数据收集表的完整性被用于衡量环境扫描的可行性。
参与地点在3个月内完成了数据收集表，大多数问题（平均87.0%）得到了回答。文化因素子主题中的问题回答最少（平均77.8%）。
总体而言，环境扫描是可行的，并发现缺乏与影响拉丁美洲医疗保健和遗传学服务接受情况的文化因素相关的已发表文献。环境因素会影响癌症遗传学服务，识别这些因素将有助于未来的合作研究和遗传学服务提供的传播工作。
