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Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program

INTRODUCTION: Population-wide genomic screening for CDC Tier-1 conditions offers the ability to identify the 1–2% of the US population at increased risk for Hereditary Breast and Ovarian Cancer, Lynch Syndrome, and Familial Hypercholesterolemia. Implementation of population-wide screening programs i...

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Autores principales: Allen, Caitlin G., Sterba, Katherine, Norman, Samantha, Jackson, Amy, Hunt, Kelly J., McMahon, Lori, Judge, Daniel P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566189/
https://www.ncbi.nlm.nih.gov/pubmed/37821977
http://dx.doi.org/10.1186/s43058-023-00500-9
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author Allen, Caitlin G.
Sterba, Katherine
Norman, Samantha
Jackson, Amy
Hunt, Kelly J.
McMahon, Lori
Judge, Daniel P.
author_facet Allen, Caitlin G.
Sterba, Katherine
Norman, Samantha
Jackson, Amy
Hunt, Kelly J.
McMahon, Lori
Judge, Daniel P.
author_sort Allen, Caitlin G.
collection PubMed
description INTRODUCTION: Population-wide genomic screening for CDC Tier-1 conditions offers the ability to identify the 1–2% of the US population at increased risk for Hereditary Breast and Ovarian Cancer, Lynch Syndrome, and Familial Hypercholesterolemia. Implementation of population-wide screening programs is highly complex, requiring engagement of diverse collaborators and implementation teams. Implementation science offers tools to promote integration of these programs through the identification of determinants of success and strategies to address potential barriers. METHODS: Prior to launching the program, we conducted a pre-implementation survey to assess anticipated barriers and facilitators to reach, effectiveness, adoption, implementation, and maintenance (RE-AIM), among 51 work group members (phase 1). During the first year of program implementation, we completed coding of 40 work group meetings guided by the Consolidated Framework for Implementation Research (CFIR) (phase 2). We matched the top barriers to implementation strategies identified during phase 2 using the CFIR-ERIC (Expert Recommendation for Implementing Change) matching tool. RESULTS: Staffing and workload concerns were listed as the top barrier in the pre-implementation phase of the program. Top barriers during implementation included adaptability (n = 8, 20%), complexity (n = 14, 35%), patient needs and resources (n = 9, 22.5%), compatibility (n = 11, 27.5%), and self-efficacy (n = 9, 22.5%). We identified 16 potential implementation strategies across six ERIC clusters to address these barriers and operationalized these strategies for our specific setting and program needs. CONCLUSION: Our findings provide an example of successful use of the CFIR-ERIC tool to guide implementation of a population-wide genomic screening program. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-023-00500-9.
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spelling pubmed-105661892023-10-12 Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program Allen, Caitlin G. Sterba, Katherine Norman, Samantha Jackson, Amy Hunt, Kelly J. McMahon, Lori Judge, Daniel P. Implement Sci Commun Research INTRODUCTION: Population-wide genomic screening for CDC Tier-1 conditions offers the ability to identify the 1–2% of the US population at increased risk for Hereditary Breast and Ovarian Cancer, Lynch Syndrome, and Familial Hypercholesterolemia. Implementation of population-wide screening programs is highly complex, requiring engagement of diverse collaborators and implementation teams. Implementation science offers tools to promote integration of these programs through the identification of determinants of success and strategies to address potential barriers. METHODS: Prior to launching the program, we conducted a pre-implementation survey to assess anticipated barriers and facilitators to reach, effectiveness, adoption, implementation, and maintenance (RE-AIM), among 51 work group members (phase 1). During the first year of program implementation, we completed coding of 40 work group meetings guided by the Consolidated Framework for Implementation Research (CFIR) (phase 2). We matched the top barriers to implementation strategies identified during phase 2 using the CFIR-ERIC (Expert Recommendation for Implementing Change) matching tool. RESULTS: Staffing and workload concerns were listed as the top barrier in the pre-implementation phase of the program. Top barriers during implementation included adaptability (n = 8, 20%), complexity (n = 14, 35%), patient needs and resources (n = 9, 22.5%), compatibility (n = 11, 27.5%), and self-efficacy (n = 9, 22.5%). We identified 16 potential implementation strategies across six ERIC clusters to address these barriers and operationalized these strategies for our specific setting and program needs. CONCLUSION: Our findings provide an example of successful use of the CFIR-ERIC tool to guide implementation of a population-wide genomic screening program. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s43058-023-00500-9. BioMed Central 2023-10-11 /pmc/articles/PMC10566189/ /pubmed/37821977 http://dx.doi.org/10.1186/s43058-023-00500-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Allen, Caitlin G.
Sterba, Katherine
Norman, Samantha
Jackson, Amy
Hunt, Kelly J.
McMahon, Lori
Judge, Daniel P.
Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
title Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
title_full Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
title_fullStr Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
title_full_unstemmed Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
title_short Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
title_sort use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566189/
https://www.ncbi.nlm.nih.gov/pubmed/37821977
http://dx.doi.org/10.1186/s43058-023-00500-9
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