PDF(Pubmed)
Abstract：
BACKGROUND: Black Kentuckians experience more deleterious colorectal cancer (CRC) outcomes than their White counterparts, a disparity that could be reduced by increased screening in Black communities. Previous research has shown that Black Kentuckians may not be equitably informed of different CRC screening options by health care providers, making community-based screening a potentially effective option among this disparate population. We used the Consolidated Framework for Implementation Research (CFIR) to identify church leaders\' perspectives of contextual factors that might influence community-based screening and explore the feasibility of using church-based screening outreach.
METHODS: Six participants were selected, based on leadership roles and interest in CRC screening, from five established Louisville-area church partners that had previously participated in community health initiatives. Data were collected, both virtually and in-person, in Summer 2021 using semi-structured interview guides developed with guidance from the CFIR Guide that focused on domains most relevant to community-based interventions. Data were transcribed verbatim, coded by two independent researchers, and member checked for accuracy.
RESULTS: Data were aligned primarily with six CFIR constructs: key stakeholders, champions, opinion leaders, tension for change, compatibility, and culture. Participants noted a strong tension for change in their community due to perceptions of inadequacy with clinical approaches to CRC screening. Additionally, they stressed the importance of identifying individuals both within the church who could champion CRC screening and help implement program activities, as well as those outside the church who could collaborate with other local organizations to increase participant reach. Finally, participants agreed that faith-based CRC screening aligned with church culture and would also likely be compatible with overall community values.
CONCLUSIONS: Overall, our church partners strongly endorsed the need for, and importance of, community-based CRC screening. Given a history of successful implementation of health promotion programs within our partner churches, it is highly likely that a CRC screening intervention would also be effective. Findings from this study will be used to identify implementation strategies that might positively impact a future faith-based CRC screening intervention, as well as CFIR constructs that are most positively associated with CRC screening completion.
METHODS: Six participants were selected, based on leadership roles and interest in CRC screening, from five established Louisville-area church partners that had previously participated in community health initiatives. Data were collected, both virtually and in-person, in Summer 2021 using semi-structured interview guides developed with guidance from the CFIR Guide that focused on domains most relevant to community-based interventions. Data were transcribed verbatim, coded by two independent researchers, and member checked for accuracy.
RESULTS: Data were aligned primarily with six CFIR constructs: key stakeholders, champions, opinion leaders, tension for change, compatibility, and culture. Participants noted a strong tension for change in their community due to perceptions of inadequacy with clinical approaches to CRC screening. Additionally, they stressed the importance of identifying individuals both within the church who could champion CRC screening and help implement program activities, as well as those outside the church who could collaborate with other local organizations to increase participant reach. Finally, participants agreed that faith-based CRC screening aligned with church culture and would also likely be compatible with overall community values.
CONCLUSIONS: Overall, our church partners strongly endorsed the need for, and importance of, community-based CRC screening. Given a history of successful implementation of health promotion programs within our partner churches, it is highly likely that a CRC screening intervention would also be effective. Findings from this study will be used to identify implementation strategies that might positively impact a future faith-based CRC screening intervention, as well as CFIR constructs that are most positively associated with CRC screening completion.
摘要：
背景：黑肯德基人的结直肠癌（CRC）结局比白人更有害，这种差距可以通过增加黑人社区的筛查来减少。先前的研究表明，医疗保健提供者可能无法公平地告知黑Kentuckians不同的CRC筛查选择，在这些不同的人群中，基于社区的筛查是一个潜在的有效选择。我们使用实施研究综合框架（CFIR）来确定教会领导者对可能影响社区筛查的环境因素的看法，并探索使用基于教会的筛查外展的可行性。
方法：选择了6名参与者，基于领导角色和对CRC筛查的兴趣，来自五个已建立的路易斯维尔地区教会合作伙伴，这些合作伙伴以前参与过社区卫生倡议。收集数据,无论是虚拟的还是面对面的，在2021年夏季，使用根据CFIR指南的指导开发的半结构化访谈指南，该指南侧重于与基于社区的干预措施最相关的领域。数据被逐字转录，由两名独立研究人员编码，和成员检查的准确性。
结果：数据主要与六个CFIR结构保持一致：关键利益相关者，冠军,意见领袖,改变的张力，兼容性,和文化。参与者指出，由于对CRC筛查的临床方法不足的看法，他们的社区变化存在强烈的压力。此外,他们强调了在教会内确定能够支持CRC筛查并帮助实施计划活动的个人的重要性，以及教会以外的人，他们可以与其他当地组织合作，以增加参与者的影响力。最后,参与者一致认为，基于信仰的CRC筛查符合教会文化，也可能符合整体社区价值观。
结论：总体而言，我们的教会伙伴强烈赞同，和重要性，基于社区的CRC筛查。鉴于在我们的伙伴教会中成功实施健康促进计划的历史，CRC筛查干预很可能也是有效的.这项研究的结果将用于确定可能对未来基于信仰的CRC筛查干预产生积极影响的实施策略。以及与CRC筛查完成最显著正相关的CFIR构建体。
方法：选择了6名参与者，基于领导角色和对CRC筛查的兴趣，来自五个已建立的路易斯维尔地区教会合作伙伴，这些合作伙伴以前参与过社区卫生倡议。收集数据,无论是虚拟的还是面对面的，在2021年夏季，使用根据CFIR指南的指导开发的半结构化访谈指南，该指南侧重于与基于社区的干预措施最相关的领域。数据被逐字转录，由两名独立研究人员编码，和成员检查的准确性。
结果：数据主要与六个CFIR结构保持一致：关键利益相关者，冠军,意见领袖,改变的张力，兼容性,和文化。参与者指出，由于对CRC筛查的临床方法不足的看法，他们的社区变化存在强烈的压力。此外,他们强调了在教会内确定能够支持CRC筛查并帮助实施计划活动的个人的重要性，以及教会以外的人，他们可以与其他当地组织合作，以增加参与者的影响力。最后,参与者一致认为，基于信仰的CRC筛查符合教会文化，也可能符合整体社区价值观。
结论：总体而言，我们的教会伙伴强烈赞同，和重要性，基于社区的CRC筛查。鉴于在我们的伙伴教会中成功实施健康促进计划的历史，CRC筛查干预很可能也是有效的.这项研究的结果将用于确定可能对未来基于信仰的CRC筛查干预产生积极影响的实施策略。以及与CRC筛查完成最显著正相关的CFIR构建体。
