Reporting Modifications from the IMPACT-FH Study Using the FRAME-IS

Area of Science:

• Genetics
• Cardiology
• Public Health

Background:

• Familial Hypercholesteremia (FH) is a genetic disorder causing high LDL-cholesterol and severe cardiac risks.
• FH is often undiagnosed, necessitating widespread screening programs.
• Cascade testing is crucial for identifying at-risk relatives of FH patients.

Purpose of the Study:

• To report modifications made to the IMPACT-FH cascade testing program.
• To analyze how implementation strategies were adapted for FH screening.
• To evaluate the role of flexibility in program implementation.

Main Methods:

• The study analyzed modifications within the IMPACT-FH cascade testing program at Geisinger.
• Implementation strategies included informational packets, chatbots, and direct contact.
• The FRAME-IS framework was used to code modifications (nature, goal, timing, impact).

Main Results:

• Eleven unplanned, reactive modifications were made during the implementation phase.
• Changes optimized the program and strategies for FH families.
• Modifications targeted the overall program (n=3), chatbot strategy (n=3), and direct contact (n=5).

Conclusions:

• Flexibility and reactive modifications were essential for successful cascade testing implementation.
• Adapting strategies enhances the effectiveness of FH screening programs.
• The IMPACT-FH trial demonstrated the value of adaptable implementation in pragmatic research.