Practice Adaptive Reserve and Colorectal Cancer Screening Best Practices at Community Health Center Clinics in 7 States

Overview

Journal Cancer

Publisher Wiley

Specialty Oncology

Date 2014 Dec 20

PMID 25524651

Citations 8

Authors

Shin-Ping Tu

Vicki M Young

Letoynia J Coombs

Rebecca S Williams

Michelle C Kegler

Amanda T Kimura

Betsy C Risendal

Daniela B Friedman

Beth A Glenn

Debbie J Pfeiffer

Maria E Fernandez

Affiliations

Soon will be listed here.

Abstract

Background: Enhancing the capability of community health centers to implement best practices (BPs) may mitigate health disparities. This study investigated the association of practice adaptive reserve (PAR) with the implementation of patient-centered medical home (PCMH) colorectal cancer (CRC) screening BPs at community health center clinics in 7 states.

Methods: A convenience sample of clinic staff participated in a self-administered, online survey. Eight PCMH CRC screening BPs were scored as a composite ranging from 0 to 32. The PAR composite score was scaled from 0 to 1 and then categorized into 3 levels. Multilevel analyses examined the relation between PAR and self-reported implementation of PCMH BPs.

Results: There were 296 respondents, and 59% reported 6 or more PCMH BPs at their clinics. The mean PAR score was 0.66 (standard deviation, 0.18), and the PCMH BP mean scores were significantly higher for respondents who reported higher clinic PAR categories. In comparison with the lowest PAR level, adjusted PCMH BP means were 25.0% higher at the middle PAR level (difference, 3.2; standard error, 1.3; t = 2.44; P = .015) and 63.2% higher at the highest PAR level (difference, 8.0; standard error, 1.9; t = 4.86; P < .0001).

Conclusions: A higher adaptive reserve, as measured by the PAR score, was positively associated with self-reported implementation of PCMH CRC screening BPs by clinic staff. Future research is needed to determine the PAR levels most conducive to implementing CRC screening and to develop interventions that enhance PAR in primary care settings.

Citing Articles

"Hypertension is such a difficult disease to manage": federally qualified health center staff- and leadership-perceived readiness to implement a technology-facilitated team-based hypertension model.

Gago C, De Leon E, Mandal S, De La Calle F, Garcia M, Colella D Implement Sci Commun. 2024; 5(1):49.

PMID: 38698497 PMC: 11067286. DOI: 10.1186/s43058-024-00587-8.

Study protocol for a type III hybrid effectiveness-implementation trial of strategies to implement firearm safety promotion as a universal suicide prevention strategy in pediatric primary care.

Beidas R, Ahmedani B, Linn K, Marcus S, Johnson C, Maye M Implement Sci. 2021; 16(1):89.

PMID: 34551811 PMC: 8456701. DOI: 10.1186/s13012-021-01154-8.

A Survey of Provider Attitudes, Beliefs, and Perceived Barriers Regarding a Centralized Direct-Mail Colorectal Cancer Screening Approach at Community Health Centers.

Thompson J, Schneider J, Rivelli J, Petrik A, Vollmer W, Fuoco M J Prim Care Community Health. 2019; 10:2150132719890950.

PMID: 31779517 PMC: 6886275. DOI: 10.1177/2150132719890950.

Organizational Leadership and Adaptive Reserve in Blood Pressure Control: The Heart Health NOW Study.

Henderson K, DeWalt D, Halladay J, Weiner B, Kim J, Fine J Ann Fam Med. 2018; 16(Suppl 1):S29-S34.

PMID: 29632223 PMC: 5891311. DOI: 10.1370/afm.2210.

Developing measures to assess constructs from the Inner Setting domain of the Consolidated Framework for Implementation Research.

Fernandez M, Walker T, Weiner B, Calo W, Liang S, Risendal B Implement Sci. 2018; 13(1):52.

PMID: 29587804 PMC: 5870186. DOI: 10.1186/s13012-018-0736-7.

References

Wagner E, Coleman K, Reid R, Phillips K, Abrams M, Sugarman J . The changes involved in patient-centered medical home transformation. Prim Care. 2012; 39(2):241-59. DOI: 10.1016/j.pop.2012.03.002. View

Woolford S, Clark S, Ahmed S, Davis M . Feasibility and acceptability of a 1-page tool to help physicians assess and discuss obesity with parents of preschoolers. Clin Pediatr (Phila). 2009; 48(9):954-9. DOI: 10.1177/0009922809338060. View

Crabtree B, Nutting P, Miller W, McDaniel R, Stange K, Jaen C . Primary care practice transformation is hard work: insights from a 15-year developmental program of research. Med Care. 2010; 49 Suppl:S28-35. PMC: 3043156. DOI: 10.1097/MLR.0b013e3181cad65c. View

Dickinson L, Basu A . Multilevel modeling and practice-based research. Ann Fam Med. 2005; 3 Suppl 1:S52-60. PMC: 1466953. DOI: 10.1370/afm.340. View

. Cancer screening - United States, 2010. MMWR Morb Mortal Wkly Rep. 2012; 61(3):41-5. View

Grimshaw J, Eccles M . Is evidence-based implementation of evidence-based care possible?. Med J Aust. 2004; 180(S6):S50-1. DOI: 10.5694/j.1326-5377.2004.tb05945.x. View

Graham I, Stewart M, Hertog M . Factors impeding the implementation of cardiovascular prevention guidelines: findings from a survey conducted by the European Society of Cardiology. Eur J Cardiovasc Prev Rehabil. 2006; 13(5):839-45. DOI: 10.1097/01.hjr.0000219112.02544.24. View

Proser M . Deserving the spotlight: health centers provide high-quality and cost-effective care. J Ambul Care Manage. 2005; 28(4):321-30. DOI: 10.1097/00004479-200510000-00007. View

Hayashi A, Selia E, McDonnell K . Stress and provider retention in underserved communities. J Health Care Poor Underserved. 2009; 20(3):597-604. DOI: 10.1353/hpu.0.0163. View

10.

Holt D, Helfrich C, Hall C, Weiner B . Are you ready? How health professionals can comprehensively conceptualize readiness for change. J Gen Intern Med. 2010; 25 Suppl 1:50-5. PMC: 2806967. DOI: 10.1007/s11606-009-1112-8. View

11.

Jaen C, Crabtree B, Palmer R, Ferrer R, Nutting P, Miller W . Methods for evaluating practice change toward a patient-centered medical home. Ann Fam Med. 2010; 8 Suppl 1:S9-20. PMC: 2885721. DOI: 10.1370/afm.1108. View

12.

Miller W, Crabtree B, Nutting P, Stange K, Jaen C . Primary care practice development: a relationship-centered approach. Ann Fam Med. 2010; 8 Suppl 1:S68-79. PMC: 2885724. DOI: 10.1370/afm.1089. View

13.

Shortell S, Jones R, Rademaker A, GILLIES R, Dranove D, HUGHES E . Assessing the impact of total quality management and organizational culture on multiple outcomes of care for coronary artery bypass graft surgery patients. Med Care. 2000; 38(2):207-17. DOI: 10.1097/00005650-200002000-00010. View

14.

Siegel R, DeSantis C, Jemal A . Colorectal cancer statistics, 2014. CA Cancer J Clin. 2014; 64(2):104-17. DOI: 10.3322/caac.21220. View

15.

Birnberg J, Drum M, Huang E, Casalino L, Lewis S, Vable A . Development of a safety net medical home scale for clinics. J Gen Intern Med. 2011; 26(12):1418-25. PMC: 3235610. DOI: 10.1007/s11606-011-1767-9. View

16.

Leykum L, Palmer R, Lanham H, Jordan M, McDaniel R, Noel P . Reciprocal learning and chronic care model implementation in primary care: results from a new scale of learning in primary care. BMC Health Serv Res. 2011; 11:44. PMC: 3050698. DOI: 10.1186/1472-6963-11-44. View

17.

Fillmore H, DuBard C, Ritter G, Jackson C . Health care savings with the patient-centered medical home: Community Care of North Carolina's experience. Popul Health Manag. 2013; 17(3):141-8. PMC: 4050704. DOI: 10.1089/pop.2013.0055. View

18.

Lemay C, Beagan B, Ferguson W, Hargraves J . Lessons learned from a collaborative to improve care for patients with diabetes in 17 community health centers, Massachusetts, 2006. Prev Chronic Dis. 2010; 7(4):A83. PMC: 2901581. View

19.

Jemal A, Siegel R, Xu J, Ward E . Cancer statistics, 2010. CA Cancer J Clin. 2010; 60(5):277-300. DOI: 10.3322/caac.20073. View

20.

Nutting P, Crabtree B, Miller W, Stewart E, Stange K, Jaen C . Journey to the patient-centered medical home: a qualitative analysis of the experiences of practices in the National Demonstration Project. Ann Fam Med. 2010; 8 Suppl 1:S45-56. PMC: 2885728. DOI: 10.1370/afm.1075. View