A5088270467- Primary Care and Health Outcomes
- Health Policy Implementation Science
- Cancer survivorship and care
- Global Cancer Incidence and Screening
- Palliative Care and End-of-Life Issues
- Cancer-related cognitive impairment studies
- Childhood Cancer Survivors' Quality of Life
- Delphi Technique in Research
- Clinical practice guidelines implementation
- Cervical Cancer and HPV Research
- Interprofessional Education and Collaboration
- Infant Development and Preterm Care
- Electronic Health Records Systems
- Early Childhood Education and Development
- Patient-Provider Communication in Healthcare
- Health Sciences Research and Education
- Patient Satisfaction in Healthcare
- Obesity and Health Practices
- Body Image and Dysmorphia Studies
- Literature Analysis and Criticism
- Healthcare Policy and Management
- Stress and Burnout Research
- Healthcare Systems and Technology
- Healthcare professionals’ stress and burnout
- Innovative Teaching and Learning Methods
Johnson University
2018-2024
Rutgers, The State University of New Jersey
2012-2024
University of Chicago
2024
Lehigh Valley Health Network
2022
University of Texas Health Science Center at Dallas
2022
VA Portland Health Care System
2018-2022
VA Center for Clinical Management Research
2018-2022
Oregon Health & Science University
2018-2022
HealthPartners
2018-2022
Pathways Behavioral Services
2018-2022
The use of implementation strategies is an active and purposive approach to translate research findings into routine clinical care. Expert Recommendations for Implementing Change (ERIC) identified defined discrete strategies, Proctor colleagues have made recommendations specifying operationalization each strategy. We empirical data test how the ERIC taxonomy applies a large dissemination initiative aimed at taking cardiac prevention scale in primary care practice. EvidenceNOW Agency...
<h3>BACKGROUND</h3> Nearly one-third of office visits for cancer are handled by primary care physicians. Yet, few studies examine patient perspectives on these physicians' roles in their follow-up or preferences. <h3>METHODS</h3> We explored survivor preferences through qualitative, semistructured, in-depth interviews drawing patients recruited from 2 National Cancer Institute–designated comprehensive centers and 6 community hospitals. a purposive sample early-stage breast prostate survivors...
Federal value-based payment programs require primary care practices to conduct quality improvement activities, informed by the electronic reports on clinical measures that their health records (EHRs) generate. To determine whether EHRs produce adequate task, we examined survey responses from 1,492 across twelve states, supplemented with qualitative data. Meaningful-use participation, which requires use of a federally certified EHR, was associated ability generate reports—but did not...
Obese women are at increased risk of developing and dying from cancer, but less likely than nonobese to receive cancer screening examinations. Our qualitative study explores obese women's barriers Pap smears mammograms in greater depth previous research. We also seek understand why some undergo whereas others do not. A purposive sample moderately severely over age 40 was recruited community-based organizations, health clinics, retail establishments. Semi-structured in-depth interviews (N =...
<h3>Background:</h3> Physician recommendation is one of the strongest, most consistent predictors colorectal cancer (CRC) screening. Little known regarding characteristics associated with patient adherence to physician recommendations in community and academic based primary care settings. <h3>Methods:</h3> Data were analyzed from 975 patients, aged ≥50 years, recruited 25 practices New Jersey. Chi-square generalized estimate equation analyses determined independent correlates receipt for...
<h3>Purpose:</h3> Practice facilitators ("facilitators") can play an important role in supporting primary care practices performing quality improvement (QI), but they need complete and accurate clinical performance data from practices9 electronic health records (EHR) to help them set priorities, guide change, monitor progress. Here, we describe the strategies use perform QI when or are not available. <h3>Methods:</h3> Seven regional cooperatives enrolled approximately 1500...
Health care extension is an approach to providing external support primary practices with the aim of diffusing innovation. EvidenceNOW was launched rapidly disseminate and implement evidence-based guidelines for cardiovascular preventive in setting. Seven regional grantee cooperatives provided foundational elements health extension—technological quality improvement support, practice capacity building, linking community resources—to more than two hundred each region. This article describes...
<h3>Background:</h3> Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed large-scale dissemination implementation initiatives. <h3>Methods:</h3> The Agency Health care Research Quality funded 7 Cooperatives, each of which worked with over 200 primary to rapidly disseminate improvements in cardiovascular preventive care. intervention target was improve...
Abstract Introduction Existing approaches in cancer survivorship care delivery have proven to be insufficient engage primary care. This study aimed identify stakeholder‐informed priorities improve engagement breast Methods Experts U.S. were invited participate a 4‐round online Delphi panel and evaluate for defining fostering care's survivorship. Panelists asked then assess (ratings of 1–9) the importance feasibility priority items support review group results reevaluate each item, aiming...
Survivor care plans have been described as useful tools for enhancing the quality of follow-up that cancer survivors receive after their active treatment has completed. The relative success current survivor plan models is strongly dependent on actions individual patients. In this qualitative study 33 survivors, we explored patients' understanding and motivations resources seeking care. Three types experiences were identified from narratives patients treated in community oncology NCI...
Primary care practices often engage in quality improvement (QI) order to stay current and meet benchmarks, but the extent which turnover affects practices' QI ability is not well described. The authors examined qualitative data from practice staff external facilitators participating a large-scale initiative understand relationship between efforts. examination found can limit activities various ways. When member leaves, remaining absorb additional responsibilities, momentum slows as new are...
Engaging primary care practices in initiatives designed to enhance quality, reduce costs, and promote safety is challenging as are already participating numerous projects mandated programs improve delivery quality. Recruiters must expand their recruitment tools engage today’s quality improvement. Using grant proposals, online diaries, observational site visits, interviews with key stakeholders, the authors identify successful practice strategies EvidenceNOW initiative, which aimed recruit...
To examine the association of prior investment on effectiveness organizations delivering large-scale external support to improve primary care.
<h3>Background:</h3> Disruptions in primary care practices, like ownership change, clinician turnover, and electronic health record system implementation, can stall quality improvement (QI) efforts. However, little is known about the relationship between these disruptions practice participation facilitated QI. <h3>Methods:</h3> We explore this using data collected from EvidenceNOW a mixed-methods convergent design. was large-scale facilitation-based QI initiative small medium practices. Data...
Despite 2 decades of cancer survivorship research, policy, and advocacy, primary care in the United States has not fully integrated into its generalist role. This manuscript describes innovative roles physicians have adopted how these emerged.
Cervical cancer disparities persist among minoritized women due to infrequent screening and poor follow-up. Structural psychosocial barriers following up with colposcopy are problematic for women. Evidence-based interventions using patient navigation tailored telephone counseling, including the Tailored Communication Cancer Risk (TC3), have modestly improved attendance. However, efficacious TC3 intervention is human resource-intense could greater reach if adapted mobile health, which...
Abstract Underrepresentation of people from racial and ethnic minoritized groups in clinical trials threatens external validity translational science, diminishes uptake innovations into practice, restricts access to the potential benefits participation. Despite efforts increase diversity trials, children adults Latino backgrounds remain underrepresented. Quality improvement concepts, strategies, tools demonstrate promise enhancing recruitment enrollment trials. To this promise, we draw upon...
BackgroundBenefits of effective team-based working in healthcare settings are well established, with the ultimate form being transdisciplinary teams. Achieving teams at large organisation or system level has not been extensively studied.PurposeTo examine and describe exemplar organisations where was enabled that can be reproduced other organisations.MethodsAn expert panel reached consensus on three USA exemplified working. Available public information about each reviewed site visits direct...
<h3>Context:</h3> Tailoring implementation strategies to translate evidence into practice is critical for enhancing uptake. Unidirectional methods of intervention design fail integrate local wisdom. This problematic when normative actionable are lacking. <h3>Objective:</h3> Describe codesign implement breast cancer survivorship follow-up care. <h3>Study Design and Analysis:</h3> Formative research included depth interviews with primary care/oncology clinicians, patient advocates, policy...
<h3>Context</h3> Patient advocacy groups engage patients, families, and caregivers in navigating the cancer landscape, focusing on early detection/screening, as well psychosocial financial support during treatment. As these have grown, they major influences over their communities, funding, policy. <h3>Objective</h3> To understand perceptions of group leaders primary care's role breast survivorship care, given a documented lack care engagement despite being endorsed receptor site by National...
<h3>BACKGROUND:</h3> Despite the emphasis of primary care's (PC) role in breast cancer follow-up improvements have had limited clinical impact. <h3>OBJECTIVE:</h3> To prioritize implementation strategies to support PC adoption evidence guide care. <h3>STUDY DESIGN AND ANALYSIS:</h3> We used an iterative, mixed method approach engaging national and local stakeholders depth interviews two (separate) Delphi panels, including expert panelists (4 rounds) health system (2 rounds). identified...