癌症筛查推广研究招募医疗计划和农村初级保健实践所需的努力和吸取的经验教训。

IF 3 Q1 PRIMARY HEALTH CARE Journal of Primary Care and Community Health Pub Date : 2024-01-01 DOI:10.1177/21501319241259915
Brittany Badicke, Jennifer Coury, Emily Myers, Amanda F Petrik, Jean Hiebert Larson, Sombuddha Bhadra, Gloria D Coronado, Melinda M Davis
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引用次数: 0

摘要

导言:招募机构(即医疗计划、医疗系统或临床实践)对实施科学非常重要,但探索让机构参与实用性研究的有效策略的研究却很有限。我们探讨了为实现务实实施试验的招募目标所需的努力、参与和未参与临床实践的特点,以及医疗计划和农村临床实践选择参与的原因:我们探讨了 SMARTER CRC(一项旨在提高农村人口 CRC 筛查率的随机务实试验)的招募活动以及与组织注册相关的因素。我们试图招募参与医疗补助健康计划的 30 家农村初级医疗机构。我们使用跟踪日志对招募外联联系人、会议内容和结果进行了跟踪。在实施研究综合框架的指导下,我们对访谈、调查和公开的临床实践数据进行了分析,以确定参与的促进因素:招募活动的总体时间跨度为 2020 年 1 月至 2021 年 4 月。在接触的 9 个医疗计划中,有 5 个同意参与(55%)。其中 3 个医疗计划根据网络结构选择作为 1 个站点集中运营,因此招募了 3 个医疗计划站点。在确定的 101 家医疗机构中,有 76 家符合研究资格标准;51%(n = 39)的医疗机构加入了研究。在招募和随机化之间,有 1 家医疗机构被排除在外,5 家退出,7 家医疗机构根据临床实践结构被合并为 3 个站点进行随机化,最后剩下 29 个随机化站点。成功招募需要在不同时间段内反复开展外联活动,每个临床实践点的招募人数从 2 人到 17 人不等。促进招募的因素包括多种模式的推广、先前的关系、有效的信息传递、灵活性和良好的时机:招募医疗计划和农村临床实践是一项复杂而反复的工作。利用现有关系并分配时间和资源,让临床实践参与到实用实施研究中,可促进未来试验中更多样化的代表性和研究结果的普遍性。
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Effort Required and Lessons Learned From Recruiting Health Plans and Rural Primary Care Practices for a Cancer Screening Outreach Study.

Introduction: Recruiting organizations (i.e., health plans, health systems, or clinical practices) is important for implementation science, yet limited research explores effective strategies for engaging organizations in pragmatic studies. We explore the effort required to meet recruitment targets for a pragmatic implementation trial, characteristics of engaged and non-engaged clinical practices, and reasons health plans and rural clinical practices chose to participate.

Methods: We explored recruitment activities and factors associated with organizational enrollment in SMARTER CRC, a randomized pragmatic trial to increase rates of CRC screening in rural populations. We sought to recruit 30 rural primary care practices within participating Medicaid health plans. We tracked recruitment outreach contacts, meeting content, and outcomes using tracking logs. Informed by the Consolidated Framework for Implementation Research, we analyzed interviews, surveys, and publicly available clinical practice data to identify facilitators of participation.

Results: Overall recruitment activities spanned January 2020 to April 2021. Five of the 9 health plans approached agreed to participate (55%). Three of the health plans chose to operate centrally as 1 site based on network structure, resulting in 3 recruited health plan sites. Of the 101 identified practices, 76 met study eligibility criteria; 51% (n = 39) enrolled. Between recruitment and randomization, 1 practice was excluded, 5 withdrew, and 7 practices were collapsed into 3 sites for randomization purposes based on clinical practice structure, leaving 29 randomized sites. Successful recruitment required iterative outreach across time, with a range of 2 to 17 encounters per clinical practice. Facilitators to recruitment included multi-modal outreach, prior relationships, effective messaging, flexibility, and good timing.

Conclusion: Recruiting health plans and rural clinical practices was complex and iterative. Leveraging existing relationships and allocating time and resources to engage clinical practices in pragmatic implementation research may facilitate more diverse representation in future trials and generalizability of research findings.

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来源期刊
CiteScore
4.80
自引率
2.80%
发文量
183
审稿时长
15 weeks
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