Spalluto Lucy B, Bonnet Kemberlee, Schlundt David, Audet Carolyn M, Henschke Claudia I, Yankelevitz David F, York Sally J, Hendler Fred, Dittus Robert S, Moghanaki Drew, Roumie Christianne L, Lewis Jennifer A
Geriatric Research Educational and Clinical Center (GRECC) and the VETWISE-LHS Center of Innovation, VA Tennessee Valley Healthcare System, Nashville, TN, USA.
Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
J Gen Intern Med. 2025 Jul 25. doi: 10.1007/s11606-025-09714-0.
Lung cancer screening program navigators improve adherence and patient experience. However, little is known about how navigators improve program outcomes.
The aim of this qualitative study was to explore factors influencing the lung cancer screening program navigator role.
From December 2020 to September 2021, we conducted a cross-sectional qualitative study of in-depth interviews in the Veterans Health Administration.
We interviewed a national sample of healthcare team members involved in lung cancer screening at 10 Veterans Affairs Medical Centers.
We performed interviews to elicit data on lung cancer screening team and organizational characteristics, barriers to and facilitators of lung cancer screening, and factors influencing the navigator role. We utilized an iterative inductive-deductive approach for qualitative analysis based on the health systems science framework and relational coordination theory.
We conducted 30 interviews (participation rate = 56%). The 30 participants were predominantly physicians (47%), in primary care (33%), and with 1-10 years of experience in current role (37%).
Participants indicated that both structural and relational factors influence the lung cancer screening program navigator role. Specifically, organizational support to strengthen the navigator's ability to function as a boundary spanner emerged as a key factor that can influence program outcomes such as efficient enrollment practices and program growth.
Healthcare team members involved in lung cancer screening indicated that navigators play an important role in impacting lung cancer screening programs. As lung cancer screening programs continue to evolve and expand, developing organizational structure and relational coordination to support navigators can positively impact program outcomes.
肺癌筛查项目导航员可提高依从性和患者体验。然而，对于导航员如何改善项目成果知之甚少。
这项定性研究的目的是探讨影响肺癌筛查项目导航员角色的因素。
2020年12月至2021年9月，我们在退伍军人健康管理局进行了一项深入访谈的横断面定性研究。
我们采访了10家退伍军人事务医疗中心参与肺癌筛查的医疗团队成员的全国样本。
我们进行访谈以获取有关肺癌筛查团队和组织特征、肺癌筛查的障碍和促进因素以及影响导航员角色的因素的数据。我们基于卫生系统科学框架和关系协调理论，采用迭代归纳-演绎方法进行定性分析。
我们进行了30次访谈（参与率=56%）。30名参与者主要是医生（47%），从事初级保健工作（33%），在当前岗位有1至10年工作经验（37%）。
参与者表示，结构因素和关系因素都会影响肺癌筛查项目导航员的角色。具体而言，加强导航员作为边界跨越者功能的组织支持成为影响项目成果（如高效登记做法和项目发展）的关键因素。
参与肺癌筛查的医疗团队成员表示，导航员在影响肺癌筛查项目方面发挥着重要作用。随着肺癌筛查项目不断发展和扩大，发展组织结构和关系协调以支持导航员可对项目成果产生积极影响。
