PDF(Pubmed)
Abstract：
Chinese Americans have lower breast and cervical cancer screening rates than the national average and experience multiple barriers to cancer care. Patient navigators have improved screening and follow-up rates for medically underserved populations, yet investigations of cancer navigation programs and their implementation among Chinese Americans are limited. To address this gap, we used the Consolidated Framework for Implementation Research (CFIR) to examine facilitators and barriers to implementing the Chicago-based Chinatown Patient Navigation Program (CPNP) for breast and cervical cancer screening, follow-up, and treatment.
Stakeholders from clinical care, supportive care services, and community organizations were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to implementing the CPNP. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including (1) intervention characteristics; (2) outer setting; (3) inner setting; and (4) the implementation process.
We interviewed a convenience sample of 16 stakeholders representing a range of roles in cancer care, including nurses, clinical team members, administrators, physicians, a community-based organization leader, and a CPNP navigator. Findings detail several facilitators to implementing the CPNP, including patient navigators that prepared Chinese-speaking patients for their clinic visits, interpretation services, highly accessible patient navigators, and high-quality flexible services. Barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement. Also, early in the program\'s implementation there was limited awareness of the CPNP navigators\' roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials.
These findings provide valuable information on implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations.
Stakeholders from clinical care, supportive care services, and community organizations were invited to participate in qualitative interviews to illuminate implementation processes and stakeholder perspectives of facilitators and barriers to implementing the CPNP. Interviews were audio-recorded, transcribed, and deductively coded according to CFIR domains, including (1) intervention characteristics; (2) outer setting; (3) inner setting; and (4) the implementation process.
We interviewed a convenience sample of 16 stakeholders representing a range of roles in cancer care, including nurses, clinical team members, administrators, physicians, a community-based organization leader, and a CPNP navigator. Findings detail several facilitators to implementing the CPNP, including patient navigators that prepared Chinese-speaking patients for their clinic visits, interpretation services, highly accessible patient navigators, and high-quality flexible services. Barriers to program implementation included limited regular feedback provided to stakeholders regarding their program involvement. Also, early in the program\'s implementation there was limited awareness of the CPNP navigators\' roles and responsibilities, insufficient office space for the navigators, and few Chinese language patient resource materials.
These findings provide valuable information on implementation of future patient navigation programs serving Chinese American and other limited-English speaking immigrant populations.
摘要：
华裔美国人的乳腺癌和宫颈癌筛查率低于全国平均水平，并且在癌症护理方面遇到了多重障碍。患者导航员提高了医疗服务不足人群的筛查和随访率，然而，对癌症导航计划的调查及其在华裔美国人中的实施是有限的。为了解决这个差距，我们使用实施研究综合框架（CFIR）来检查促进者和障碍，以实施总部位于芝加哥的唐人街患者导航计划（CPNP）的乳腺癌和宫颈癌筛查，后续行动,和治疗。
来自临床护理的利益相关者，支持性护理服务，和社区组织被邀请参加定性访谈，以阐明实施过程和利益相关者对促进者的看法以及实施CPNP的障碍。采访是录音的，转录，并根据CFIR域进行演绎编码，包括(1)干预特征;(2)外部设置;(3)内部设置;(4)实施过程。
我们采访了16位利益相关者的便利样本，这些利益相关者代表了癌症护理中的一系列角色。包括护士,临床团队成员,管理员,医师,以社区为基础的组织领导人，和CPNP导航员。调查结果详细介绍了实施CPNP的几位促进者，包括为说中文的患者的诊所就诊做好准备的患者导航员，口译服务,高度接近的病人导航仪，和高质量的灵活服务。计划实施的障碍包括向利益相关者提供有关其计划参与的有限定期反馈。此外，在该计划的实施初期，对CPNP导航员的角色和责任的认识有限，航海家的办公空间不够,中文病人资料很少。
这些发现为未来的患者导航计划的实施提供了有价值的信息，该计划为美籍华人和其他英语有限的移民人口服务。
来自临床护理的利益相关者，支持性护理服务，和社区组织被邀请参加定性访谈，以阐明实施过程和利益相关者对促进者的看法以及实施CPNP的障碍。采访是录音的，转录，并根据CFIR域进行演绎编码，包括(1)干预特征;(2)外部设置;(3)内部设置;(4)实施过程。
我们采访了16位利益相关者的便利样本，这些利益相关者代表了癌症护理中的一系列角色。包括护士,临床团队成员,管理员,医师,以社区为基础的组织领导人，和CPNP导航员。调查结果详细介绍了实施CPNP的几位促进者，包括为说中文的患者的诊所就诊做好准备的患者导航员，口译服务,高度接近的病人导航仪，和高质量的灵活服务。计划实施的障碍包括向利益相关者提供有关其计划参与的有限定期反馈。此外，在该计划的实施初期，对CPNP导航员的角色和责任的认识有限，航海家的办公空间不够,中文病人资料很少。
这些发现为未来的患者导航计划的实施提供了有价值的信息，该计划为美籍华人和其他英语有限的移民人口服务。
