Facilitators to implementing preventive health interventions for adolescents in the emergency department: A multicenter qualitative analysis.

IF 3.4 3区 医学 Q1 EMERGENCY MEDICINE Academic Emergency Medicine Pub Date : 2024-11-05 DOI:10.1111/acem.15043
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
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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.

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在急诊科对青少年实施预防性健康干预的促进因素:多中心定性分析。
目的:青少年经常使用急诊科(ED)来满足他们的医疗保健需求,许多青少年将急诊科作为他们的主要医疗机构。因此,急诊科非常适合为大量青少年提供预防保健服务。这项多中心定性分析的目的是找出影响急诊室对青少年患者实施预防性保健干预的因素:我们对来自不同地区的五所儿科急诊室的医护人员(HCP)进行了半结构化访谈。我们制定了访谈指南,以探讨急诊室医护人员对实施预防性保健干预措施的态度和信念。访谈由三名研究人员记录、转录和编码。实施研究综合框架 (CFIR) 被用作对访谈数据进行编码和分析的指南。我们合作产生了一些主题,这些主题代表了在急诊室环境中促进对青少年患者实施预防性健康干预的因素:我们进行了 38 次访谈(18 名儿科急诊医学主治医师/研究员、11 名注册护士、5 名执业护士或 4 名医生助理)。我们在五个 CFIR 领域提出了 10 个主题:创新特点(设计干预措施以促进青少年参与)、内部环境(将干预措施纳入急诊室工作流程和范围、尽量减轻提供者的负担)、外部环境(让社区参与进来、与部门和机构的使命保持一致)、个人(确定支持者)和实施过程(让主要利益相关者尽早参与进来、有耐心、针对所有患者以减少耻辱感):促进在急诊室对青少年患者实施预防性保健干预措施的因素包括多个 CFIR 领域,阐明了在急诊室对这一患者群体实施预防性保健干预措施需要综合考虑众多因素。这些数据提出了加强和促进急诊室青少年预防性健康干预措施实施的方法。
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来源期刊
Academic Emergency Medicine
Academic Emergency Medicine 医学-急救医学
CiteScore
7.60
自引率
6.80%
发文量
207
审稿时长
3-8 weeks
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.
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