Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study
Abstract Introduction: Evidence-based interventions (EBIs) exist to increase colorectal cancer (CRC) screening, but implementation remains slow in federally qualified health centers (FQHCs). Assessing organizational readiness can improve EBI implementation outcomes, but no studies have quantitativ...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Journal of Clinical and Translational Science |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2059866124006897/type/journal_article |
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| author | Emanuelle M. Dias Timothy J. Walker Bijal A. Balasubramanian Paula M. Cuccaro Lauren Workman Abraham Wandersman Maria E. Fernandez |
| author_facet | Emanuelle M. Dias Timothy J. Walker Bijal A. Balasubramanian Paula M. Cuccaro Lauren Workman Abraham Wandersman Maria E. Fernandez |
| author_sort | Emanuelle M. Dias |
| collection | DOAJ |
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Abstract
Introduction:
Evidence-based interventions (EBIs) exist to increase colorectal cancer (CRC) screening, but implementation remains slow in federally qualified health centers (FQHCs). Assessing organizational readiness can improve EBI implementation outcomes, but no studies have quantitatively examined the relation between organizational readiness subcomponents and implementation outcomes. This study examines associations between readiness subcomponents and CRC screening EBI implementation outcomes in FQHCs.
Methods:
We used data from an ongoing parent study to develop an organizational readiness measure using the R = MC2 heuristic. We conducted descriptive and cross-sectional analyses using FQHC clinic (n = 57) data across three states. A clinic contact completed a survey about clinic characteristics and then distributed an EBI-specific survey to clinic staff containing readiness and implementation questions about Community Guide EBIs (e.g., patient reminders). Pearson correlations assessed bivariate associations between readiness variables and implementation outcomes. We then computed multivariable linear associations between readiness variables and implementation outcomes while controlling for clinic-level variables. One-way analysis of variance tested group differences in readiness subcomponent mean scores using EBI implementation responses.
Results:
Respondents’ most common job type was medical assistant, and the most frequently implemented EBIs were provider or patient reminders. Organizational structure was associated with implementing patient reminders. Clinics reporting inconsistent implementation had lower organizational structure scores than clinics planning or fully implementing patient reminders.
Conclusion:
This study guides researchers in prioritizing organizational structure and selecting specific implementation strategies to improve this construct to implement CRC screening-related EBIs. Future research should examine these associations using a larger sample size to explore additional relations between organizational readiness and implementation outcomes.
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| format | Article |
| id | doaj-art-6bced892c5db40c8986b9a14e85c0841 |
| institution | Kabale University |
| issn | 2059-8661 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Journal of Clinical and Translational Science |
| spelling | doaj-art-6bced892c5db40c8986b9a14e85c08412025-01-31T09:21:58ZengCambridge University PressJournal of Clinical and Translational Science2059-86612025-01-01910.1017/cts.2024.689Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional studyEmanuelle M. Dias0https://orcid.org/0000-0001-9040-9376Timothy J. Walker1Bijal A. Balasubramanian2Paula M. Cuccaro3Lauren Workman4Abraham Wandersman5Maria E. Fernandez6UTHealth Houston School of Public Health, Houston, TX, USAUTHealth Houston School of Public Health, Houston, TX, USA UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USAUTHealth Houston School of Public Health, Houston, TX, USA UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USAUTHealth Houston School of Public Health, Houston, TX, USA UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USACenter for Applied Research and Evaluation, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA Department of Health Services, Policy, and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USAWandersman Center, Columbia, SC, USAUTHealth Houston School of Public Health, Houston, TX, USA UTHealth Houston Institute for Implementation Science, UTHealth Houston School of Public Health, Houston, TX, USA Abstract Introduction: Evidence-based interventions (EBIs) exist to increase colorectal cancer (CRC) screening, but implementation remains slow in federally qualified health centers (FQHCs). Assessing organizational readiness can improve EBI implementation outcomes, but no studies have quantitatively examined the relation between organizational readiness subcomponents and implementation outcomes. This study examines associations between readiness subcomponents and CRC screening EBI implementation outcomes in FQHCs. Methods: We used data from an ongoing parent study to develop an organizational readiness measure using the R = MC2 heuristic. We conducted descriptive and cross-sectional analyses using FQHC clinic (n = 57) data across three states. A clinic contact completed a survey about clinic characteristics and then distributed an EBI-specific survey to clinic staff containing readiness and implementation questions about Community Guide EBIs (e.g., patient reminders). Pearson correlations assessed bivariate associations between readiness variables and implementation outcomes. We then computed multivariable linear associations between readiness variables and implementation outcomes while controlling for clinic-level variables. One-way analysis of variance tested group differences in readiness subcomponent mean scores using EBI implementation responses. Results: Respondents’ most common job type was medical assistant, and the most frequently implemented EBIs were provider or patient reminders. Organizational structure was associated with implementing patient reminders. Clinics reporting inconsistent implementation had lower organizational structure scores than clinics planning or fully implementing patient reminders. Conclusion: This study guides researchers in prioritizing organizational structure and selecting specific implementation strategies to improve this construct to implement CRC screening-related EBIs. Future research should examine these associations using a larger sample size to explore additional relations between organizational readiness and implementation outcomes. https://www.cambridge.org/core/product/identifier/S2059866124006897/type/journal_articleOrganizational readinessimplementationcolorectal cancer screeningevidence-based interventionsfederally qualified health centersorganizational structure |
| spellingShingle | Emanuelle M. Dias Timothy J. Walker Bijal A. Balasubramanian Paula M. Cuccaro Lauren Workman Abraham Wandersman Maria E. Fernandez Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study Journal of Clinical and Translational Science Organizational readiness implementation colorectal cancer screening evidence-based interventions federally qualified health centers organizational structure |
| title | Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study |
| title_full | Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study |
| title_fullStr | Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study |
| title_full_unstemmed | Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study |
| title_short | Organizational readiness and implementation of colorectal cancer screening evidence-based interventions in federally qualified health centers: A cross-sectional study |
| title_sort | organizational readiness and implementation of colorectal cancer screening evidence based interventions in federally qualified health centers a cross sectional study |
| topic | Organizational readiness implementation colorectal cancer screening evidence-based interventions federally qualified health centers organizational structure |
| url | https://www.cambridge.org/core/product/identifier/S2059866124006897/type/journal_article |
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