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Examining Factors Influencing Colorectal Cancer Screening of Rural Nebraskans Using Data from Clinics Participating in an Accountable Care Organization: A Study Protocol.

Young L, Kim J, Wang H, Chen LW - F1000Res (2015)

Bottom Line: Although mortality rates of colorectal cancer (CRC) can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts.Both quantitative and qualitative data will be merged for result interpretation.The study findings will enhance our understanding of how the ACO model, particularly in rural areas, interacts with provider- and patient-level factors influencing the CRC screening rate of rural patients.

View Article: PubMed Central - PubMed

Affiliation: College of Nursing, Lincoln Division, University of Nebraska Medical Center, Omaha, NE, 68198, USA.

ABSTRACT

Background: Although mortality rates of colorectal cancer (CRC) can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts. Understanding and eliminating barriers to cancer screening will decrease cancer burden and lead to substantial gains in quality and quantity of life for rural populations. However, existing studies have shown inconsistent findings and fail to address how contextual and provider-level factors impact CRC screening in addition to individual-level factors. 

Purpose: The purpose of the study is to examine multi-level factors related to CRC screening, and providers' perception of barriers and facilitators of CRC screening in rural patients cared for by accountable care organization (ACO) clinics.

Methods/design: This is a convergent mixed method design. For the quantitative component, multiple data sources, such as electronic health records (EHRs), Area Resource File (ARF), and provider survey data, will be used to examine patient-, provider-, clinic-, and county-level factors. About 21,729 rural patients aged between 50 and 75 years who visited the participating ACO clinics in the past 12 months are included in the quantitative analysis. The qualitative methods include semi-structured in-depth interviews with healthcare professionals in selected rural clinics. Both quantitative and qualitative data will be merged for result interpretation. Quantitative data identifies "what" factors influence CRC screening, while qualitative data explores "how" these factors interact with CRC screening. The study setting is 10 ACO clinics located in nine rural Nebraska counties.

Discussion: This will be the first study examining multi-level factors related to CRC screening in the new healthcare delivery system (i.e., ACO clinics) in rural communities. The study findings will enhance our understanding of how the ACO model, particularly in rural areas, interacts with provider- and patient-level factors influencing the CRC screening rate of rural patients.

No MeSH data available.


Related in: MedlinePlus

Conceptual Framework of the Proposed Study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
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f1: Conceptual Framework of the Proposed Study.

Mentions: Based on our literature review and clinical expert input, we developed a conceptual framework derived from Gelberg-Anderson’s healthcare use behavioral model33. The conceptual framework will assist in understanding rural residents’ cancer screening behavior and its correlation with individual, provider, and county level factors (Figure 1). The model posits that cancer screening is a function of predisposing factors, enabling factors and needs at both the patient and provider levels. The model also posits that county-level factors, such as socioeconomic indicators and rural health resources, influence patient- and provider-level factors. The hypothesis illustrated by the conceptual framework will direct us in study design, variable selection, outcome measure, data collection and analysis, as well as in result interpretation.


Examining Factors Influencing Colorectal Cancer Screening of Rural Nebraskans Using Data from Clinics Participating in an Accountable Care Organization: A Study Protocol.

Young L, Kim J, Wang H, Chen LW - F1000Res (2015)

Conceptual Framework of the Proposed Study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4544372&req=5

f1: Conceptual Framework of the Proposed Study.
Mentions: Based on our literature review and clinical expert input, we developed a conceptual framework derived from Gelberg-Anderson’s healthcare use behavioral model33. The conceptual framework will assist in understanding rural residents’ cancer screening behavior and its correlation with individual, provider, and county level factors (Figure 1). The model posits that cancer screening is a function of predisposing factors, enabling factors and needs at both the patient and provider levels. The model also posits that county-level factors, such as socioeconomic indicators and rural health resources, influence patient- and provider-level factors. The hypothesis illustrated by the conceptual framework will direct us in study design, variable selection, outcome measure, data collection and analysis, as well as in result interpretation.

Bottom Line: Although mortality rates of colorectal cancer (CRC) can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts.Both quantitative and qualitative data will be merged for result interpretation.The study findings will enhance our understanding of how the ACO model, particularly in rural areas, interacts with provider- and patient-level factors influencing the CRC screening rate of rural patients.

View Article: PubMed Central - PubMed

Affiliation: College of Nursing, Lincoln Division, University of Nebraska Medical Center, Omaha, NE, 68198, USA.

ABSTRACT

Background: Although mortality rates of colorectal cancer (CRC) can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts. Understanding and eliminating barriers to cancer screening will decrease cancer burden and lead to substantial gains in quality and quantity of life for rural populations. However, existing studies have shown inconsistent findings and fail to address how contextual and provider-level factors impact CRC screening in addition to individual-level factors. 

Purpose: The purpose of the study is to examine multi-level factors related to CRC screening, and providers' perception of barriers and facilitators of CRC screening in rural patients cared for by accountable care organization (ACO) clinics.

Methods/design: This is a convergent mixed method design. For the quantitative component, multiple data sources, such as electronic health records (EHRs), Area Resource File (ARF), and provider survey data, will be used to examine patient-, provider-, clinic-, and county-level factors. About 21,729 rural patients aged between 50 and 75 years who visited the participating ACO clinics in the past 12 months are included in the quantitative analysis. The qualitative methods include semi-structured in-depth interviews with healthcare professionals in selected rural clinics. Both quantitative and qualitative data will be merged for result interpretation. Quantitative data identifies "what" factors influence CRC screening, while qualitative data explores "how" these factors interact with CRC screening. The study setting is 10 ACO clinics located in nine rural Nebraska counties.

Discussion: This will be the first study examining multi-level factors related to CRC screening in the new healthcare delivery system (i.e., ACO clinics) in rural communities. The study findings will enhance our understanding of how the ACO model, particularly in rural areas, interacts with provider- and patient-level factors influencing the CRC screening rate of rural patients.

No MeSH data available.


Related in: MedlinePlus