RT Journal Article
SR Electronic
T1 Primary Care Providers Experiences Implementing Low-Dose Computed Tomography Recommendations for Lung Cancer Screening
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP jabfm.2023.230109R1
DO 10.3122/jabfm.2023.230109R1
A1 Golden, Sara E.
A1 Currier, Jessica J.
A1 Ramalingam, NithyaPriya
A1 Patzel, Mary
A1 Shannon, Jackilen
A1 Davis, Melinda M.
A1 Slatore, Christopher G.
YR 2023
UL http://www.jabfm.org/content/early/2023/12/13/jabfm.2023.230109R1.abstract
AB Purpose: Describe primary care providers’ (PCPs) barriers and facilitators to implementation of lung cancer screening programs in rural settings.Methods: We conducted qualitative interviews with PCPs practicing in rural Oregon from November 2019 to September 2020. The interview questions and analytic framework were informed by the 2009 Consolidated Framework for Implementation Research. We used inductive and deductive approaches for analysis.Results: We interviewed 15 key participants from 12 distinct health care systems. We identified several Consolidated Framework for Implementation Research factors affecting lung cancer screening implementation. 1) Most PCPs did not have workflows to assist in discussing screening and relied on their memory and knowledge of the patient’s history to prompt discussions. PCPs supported screening and managed the patient throughout the process. 2) PCPs reported several patient-level barriers, including geographic access to lung cancer screening scans and out-of-pocket cost concerns. 3) PCPs reported that champions are necessary to create opportunities for local practices to adopt lung cancer screening programs.Conclusions: Rural-practicing PCPs were supportive of lung cancer screening, however workflow processes, time challenges, and patient-reported barriers remain impediments to improved screening in their clinics. We identified several areas for improvement in lung cancer screening implementation in rural primary care practices, ranging from designing clinic workflows and processes to designating clinic staff to support referral, screening, and follow-up care for patients.