Primary Care Providers Experiences Implementing Low-Dose Computed Tomography Recommendations for Lung Cancer...

Area of Science:

• Implementation Science
• Rural Health
• Oncology

Background:

• Lung cancer screening is crucial for early detection and improved survival rates.
• Rural primary care settings face unique challenges in implementing new health programs.
• Understanding barriers and facilitators is key to successful program adoption.

Purpose of the Study:

• To identify barriers and facilitators for primary care providers (PCPs) implementing lung cancer screening programs in rural settings.
• To inform strategies for enhancing lung cancer screening uptake in underserved areas.

Main Methods:

• Qualitative interviews conducted with 15 PCPs across 12 rural Oregon health care systems.
• Analysis guided by the Consolidated Framework for Implementation Research (CFIR).
• Inductive and deductive analytical approaches were employed.

Main Results:

• PCPs lacked standardized workflows for lung cancer screening discussions, relying on patient history and memory.
• Patient-level barriers included geographic access to screening scans and out-of-pocket costs.
• Designated 'champions' and clinic staff support were identified as crucial facilitators for program adoption.

Conclusions:

• Rural PCPs are supportive of lung cancer screening but require enhanced clinic workflows and processes.
• Addressing patient-related barriers like access and cost is essential for successful implementation.
• Designating staff to manage referrals, screening, and follow-up care can optimize lung cancer screening programs in rural primary care.