PDF(Pubmed)
Abstract：
OBJECTIVE: We examined the extent to which funded satellite clinics could sustain the California Colon Cancer Control Program (C4P) strategies implemented in health systems to increase uptake of the fecal immunochemical test (FIT) or immunochemical fecal occult blood test (iFOBT) for colorectal cancer (CRC) screening in the absence of future C4P funds.
BACKGROUND: Seven health systems consisting of 38 satellite clinics participated in C4P to examine the sustainability of the program in the absence future Centers for Disease Control and Prevention (CDC) funding.
METHODS: Quantitative and qualitative methods with a close and open-ended survey approach, and a prospective cohort design were used to examine the sustainability of the C4P in health systems.
RESULTS: A total of 61% of satellite clinics could not sustain funding stability. Only 26% could sustain funding stability. About, 71%, 26%, and 21% of the satellite clinics could sustain the small media platform, patient navigation services, and community health workers (CHWs), respectively. All the satellite clinics sustained the provider reminder system and professional development. Roughly, 71% and 42% of funded satellite clinics could not sustain the patient navigators and CHWs, respectively. The satellite clinics that could sustain funding stability, sustained patient navigation services and CHWs. Health systems that could not sustain funding stability, could not sustain patient navigation services and CHWs. Qualitatively, the need to support uninsured priority populations, health educators, patient navigators, care coordination activities, outreach services, and provision of enhanced services emerged. The need to support enhanced quality measures, expansion of funding, Medi-Cal Public Hospital Redesign and Incentive coverage, health plan, community linkages, resource sharing, and best practices specifically on CRC screening emerged. Themes such as automated reminder, limited personalized care delivery and capacity, transportation barriers, staff salary, expansion of care through patient navigation, and culturally appropriate media campaign also emerged.
CONCLUSIONS: Overall, to address sustainability barriers, funding stability should be maintained in the health systems.
BACKGROUND: Seven health systems consisting of 38 satellite clinics participated in C4P to examine the sustainability of the program in the absence future Centers for Disease Control and Prevention (CDC) funding.
METHODS: Quantitative and qualitative methods with a close and open-ended survey approach, and a prospective cohort design were used to examine the sustainability of the C4P in health systems.
RESULTS: A total of 61% of satellite clinics could not sustain funding stability. Only 26% could sustain funding stability. About, 71%, 26%, and 21% of the satellite clinics could sustain the small media platform, patient navigation services, and community health workers (CHWs), respectively. All the satellite clinics sustained the provider reminder system and professional development. Roughly, 71% and 42% of funded satellite clinics could not sustain the patient navigators and CHWs, respectively. The satellite clinics that could sustain funding stability, sustained patient navigation services and CHWs. Health systems that could not sustain funding stability, could not sustain patient navigation services and CHWs. Qualitatively, the need to support uninsured priority populations, health educators, patient navigators, care coordination activities, outreach services, and provision of enhanced services emerged. The need to support enhanced quality measures, expansion of funding, Medi-Cal Public Hospital Redesign and Incentive coverage, health plan, community linkages, resource sharing, and best practices specifically on CRC screening emerged. Themes such as automated reminder, limited personalized care delivery and capacity, transportation barriers, staff salary, expansion of care through patient navigation, and culturally appropriate media campaign also emerged.
CONCLUSIONS: Overall, to address sustainability barriers, funding stability should be maintained in the health systems.
摘要：
目的：我们研究了资助的卫星诊所在多大程度上可以维持在卫生系统中实施的加利福尼亚结肠癌控制计划（C4P）策略，以增加粪便免疫化学测试（FIT）或免疫化学粪便隐血测试（iFOBT）的吸收，用于结直肠癌（CRC）筛查。
背景：在没有未来疾病控制和预防中心（CDC）资助的情况下，由38个卫星诊所组成的七个卫生系统参加了C4P，以检查该计划的可持续性。
方法：定量和定性方法，采用封闭式和开放式调查方法，我们采用前瞻性队列设计来研究C4P在卫生系统中的可持续性.
结果：总共61%的卫星诊所无法维持资金稳定。只有26%的人能够维持资金稳定。关于,71%,26%,21%的卫星诊所可以维持小型媒体平台，患者导航服务，和社区卫生工作者(CHW)，分别。所有卫星诊所都维持了提供者提醒系统和专业发展。粗略地,71％和42％的资助卫星诊所无法维持患者导航员和CHW，分别。可以维持资金稳定的卫星诊所，持续的患者导航服务和CHW。无法维持资金稳定的卫生系统，无法维持患者导航服务和CHW。定性,需要支持没有保险的优先人群，健康教育者，耐心的导航员，护理协调活动，外展服务，并提供了增强的服务。需要支持增强的质量措施，扩大资金，Medi-Cal公立医院重新设计和奖励覆盖范围，健康计划,社区联系，资源共享,出现了专门针对CRC筛查的最佳实践。自动提醒等主题，有限的个性化护理服务和能力，交通障碍,员工工资,通过患者导航扩展护理，和文化上适当的媒体运动也出现了。
结论：总体而言，为了解决可持续性障碍，卫生系统应保持资金稳定。
背景：在没有未来疾病控制和预防中心（CDC）资助的情况下，由38个卫星诊所组成的七个卫生系统参加了C4P，以检查该计划的可持续性。
方法：定量和定性方法，采用封闭式和开放式调查方法，我们采用前瞻性队列设计来研究C4P在卫生系统中的可持续性.
结果：总共61%的卫星诊所无法维持资金稳定。只有26%的人能够维持资金稳定。关于,71%,26%,21%的卫星诊所可以维持小型媒体平台，患者导航服务，和社区卫生工作者(CHW)，分别。所有卫星诊所都维持了提供者提醒系统和专业发展。粗略地,71％和42％的资助卫星诊所无法维持患者导航员和CHW，分别。可以维持资金稳定的卫星诊所，持续的患者导航服务和CHW。无法维持资金稳定的卫生系统，无法维持患者导航服务和CHW。定性,需要支持没有保险的优先人群，健康教育者，耐心的导航员，护理协调活动，外展服务，并提供了增强的服务。需要支持增强的质量措施，扩大资金，Medi-Cal公立医院重新设计和奖励覆盖范围，健康计划,社区联系，资源共享,出现了专门针对CRC筛查的最佳实践。自动提醒等主题，有限的个性化护理服务和能力，交通障碍,员工工资,通过患者导航扩展护理，和文化上适当的媒体运动也出现了。
结论：总体而言，为了解决可持续性障碍，卫生系统应保持资金稳定。
