Emily Rutland, Mona Bugaighis, Andrea T Cruz, Monika K Goyal, Rakesh D Mistry, Jennifer L Reed, John S Santelli, Peter S Dayan, Lauren S Chernick
{"title":"Facilitators to implementing preventive health interventions for adolescents in the emergency department: A multicenter qualitative analysis.","authors":"Emily Rutland, Mona Bugaighis, Andrea T Cruz, Monika K Goyal, Rakesh D Mistry, Jennifer L Reed, John S Santelli, Peter S Dayan, Lauren S Chernick","doi":"10.1111/acem.15043","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Adolescents frequently use the emergency department (ED) to meet their health care needs, and many use the ED as their primary source of care. The ED is therefore well situated to provide preventive health care to large numbers of adolescents. The objective of this multicenter qualitative analysis was to identify factors that influence the implementation of preventive health care interventions for adolescent patients in the ED.</p><p><strong>Methods: </strong>We conducted semistructured interviews with ED health care providers (HCPs) from five academic pediatric EDs in distinct geographic regions. We developed an interview guide to explore HCP attitudes and beliefs related to implementing preventive health interventions in the ED. Interviews were recorded, transcribed, and coded by three investigators. The Consolidated Framework for Implementation Research (CFIR) was used as a guide to code and analyze interview data. We collaboratively generated themes that represent factors that are perceived to facilitate the implementation of preventive health interventions for adolescent patients in the ED setting.</p><p><strong>Results: </strong>We conducted 38 interviews (18 pediatric emergency medicine attendings/fellows, 11 registered nurses, five nurse practitioners, or and four physician assistants). We generated 10 themes across the five CFIR domains: innovation characteristics (designing interventions to promote adolescent engagement), inner setting (integrating interventions into ED workflow and scope, minimizing provider burden), outer setting (involving the community, aligning with departmental and institutional missions), individuals (identifying champions), and implementation process (involving key stakeholders early, having patience, and targeting all patients to reduce stigma).</p><p><strong>Conclusions: </strong>Factors facilitating implementation of preventive health interventions for adolescent patients in the ED encompassed multiple CFIR domains, elucidating how the delivery of preventive health interventions for this patient population in the ED requires considering numerous factors comprehensively. These data suggest methods to enhance and facilitate implementation of preventive health interventions for adolescents in the ED.</p>","PeriodicalId":7105,"journal":{"name":"Academic Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic Emergency Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/acem.15043","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: Adolescents frequently use the emergency department (ED) to meet their health care needs, and many use the ED as their primary source of care. The ED is therefore well situated to provide preventive health care to large numbers of adolescents. The objective of this multicenter qualitative analysis was to identify factors that influence the implementation of preventive health care interventions for adolescent patients in the ED.
Methods: We conducted semistructured interviews with ED health care providers (HCPs) from five academic pediatric EDs in distinct geographic regions. We developed an interview guide to explore HCP attitudes and beliefs related to implementing preventive health interventions in the ED. Interviews were recorded, transcribed, and coded by three investigators. The Consolidated Framework for Implementation Research (CFIR) was used as a guide to code and analyze interview data. We collaboratively generated themes that represent factors that are perceived to facilitate the implementation of preventive health interventions for adolescent patients in the ED setting.
Results: We conducted 38 interviews (18 pediatric emergency medicine attendings/fellows, 11 registered nurses, five nurse practitioners, or and four physician assistants). We generated 10 themes across the five CFIR domains: innovation characteristics (designing interventions to promote adolescent engagement), inner setting (integrating interventions into ED workflow and scope, minimizing provider burden), outer setting (involving the community, aligning with departmental and institutional missions), individuals (identifying champions), and implementation process (involving key stakeholders early, having patience, and targeting all patients to reduce stigma).
Conclusions: Factors facilitating implementation of preventive health interventions for adolescent patients in the ED encompassed multiple CFIR domains, elucidating how the delivery of preventive health interventions for this patient population in the ED requires considering numerous factors comprehensively. These data suggest methods to enhance and facilitate implementation of preventive health interventions for adolescents in the ED.
期刊介绍:
Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine.
The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more.
Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.