Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program
Abstract 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 pr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
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| Series: | Implementation Science Communications |
| Online Access: | https://doi.org/10.1186/s43058-023-00500-9 |
| _version_ | 1827634102792093696 |
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| author | Caitlin G. Allen Katherine Sterba Samantha Norman Amy Jackson Kelly J. Hunt Lori McMahon Daniel P. Judge |
| author_facet | Caitlin G. Allen Katherine Sterba Samantha Norman Amy Jackson Kelly J. Hunt Lori McMahon Daniel P. Judge |
| author_sort | Caitlin G. Allen |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-03-09T15:08:44Z |
| format | Article |
| id | doaj.art-453a55a949ee4cfab99ab2744b282f33 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-03-09T15:08:44Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-453a55a949ee4cfab99ab2744b282f332023-11-26T13:29:08ZengBMCImplementation Science Communications2662-22112023-10-014111310.1186/s43058-023-00500-9Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening programCaitlin G. Allen0Katherine Sterba1Samantha Norman2Amy Jackson3Kelly J. Hunt4Lori McMahon5Daniel P. Judge6Department of Public Health Science, College of Medicine, Medical University of South CarolinaDepartment of Public Health Science, College of Medicine, Medical University of South CarolinaIn Our DNA SC, Medical University of South CarolinaIn Our DNA SC, Medical University of South CarolinaDepartment of Public Health Science, College of Medicine, Medical University of South CarolinaResearch Office, Medical University of South CarolinaIn Our DNA SC, Medical University of South CarolinaAbstract 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.https://doi.org/10.1186/s43058-023-00500-9 |
| spellingShingle | Caitlin G. Allen Katherine Sterba Samantha Norman Amy Jackson Kelly J. Hunt Lori McMahon Daniel P. Judge Use of a multi-phased approach to identify and address facilitators and barriers to the implementation of a population-wide genomic screening program Implementation Science Communications |
| 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 |
| url | https://doi.org/10.1186/s43058-023-00500-9 |
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