Abstract
Background: Relatives of breast cancer patients often face substantial uncertainty
and psychological stress regarding their own health risks and optimal strategies for
prevention and early detection. Efficacious educational and counseling interventions
are rarely evaluated for their potential adoption and use in medical practice settings.
This study evaluates a health education program for first-degree relatives of breast
cancer patients based on the program’s potential for being adopted and used by medical
practices affiliated with cancer centers.
Methods: A randomized, controlled trial was implemented in four community hospital–based
medical practices. After 9 months, clinical and administrative staff at each practice
were given self-administered surveys. Of 90 staff members recruited to respond, useable
responses were received from 60 (67%), including 13 physicians (31%), 43 nurses (98%),
and four program managers (100%). Participants made self-reports of program awareness,
program support, perceived program performance, likelihood of program adoption and
use, and barriers to adoption.
Results: A strong majority of respondents (80%) reported that all or most staff agreed
with the need for the program. Perceived program performance in meeting goals was
generally favorable but varied across sites and across staff types. Overall, 56% of
respondents indicated that their practices were likely or highly likely to adopt the
program in full. The likelihood of adoption varied substantially across sites and
across program components.
Conclusions: Evaluating the potential for program adoption offers insight for tailoring
preventive health interventions and their implementation strategies to improve diffusion
in the field of practice.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- A randomized trial of breast cancer risk counseling.Health Psychol. 1996; 15: 75-83
- Awareness of heightened breast cancer risk among first-degree relatives of recently diagnosed breast cancer patients. The High Risk Breast Cancer Consortium.Cancer Epidemiol Biomarkers Prev. 1995; 4: 561-565
- Participation in a women’s breast cancer risk counseling trial. Who participates? Who declines? High Risk Breast Cancer Consortium.Cancer. 1996; 77: 2348-2355
- Transactional theory and research on emotions and coping.Eur J Pers. 1987; 1: 141-169
- Projecting individualized probabilities of developing breast cancer for white females who are being examined annually.J Natl Cancer Inst. 1989; 81: 1879-1886
- Secondary prevention of excessive alcohol use.Fam Pract. 1996; 13: 182-193
- Diffusion of Innovations, 5th ed. Free Press, New York1995
- Managing organizational change and innovation.in: Shortell S Kaluzny A.D Health care management a text in organizational theory and behavior. Wiley and Sons, New York1988
- Innovation in medical care organizations.Med Care Rev. 1990; 47: 165-192
- Strategic stakeholder management.’ Med Group Manage J. 1995; 42: 16-21
- The problematic fit of diagnosis and strategy for medical group stakeholders—including IDS/Ns.Health Care Manage Rev. 1996; 21: 7-28
- Innovations and organizations. John Wiley and Sons, New York1973
- Managerial practices that enhance innovation.Organ Dyn. 1985; 14: 24-34
- Ensuring access to quality care.in: Kaluzny A Warnecke R Managing a health care alliance:improving community cancer care. Jossey-Bass, San Francisco, CA1996
- Using a community cancer treatment trials network for cancer prevention and control research.Cancer Epidemiol Biomarkers Prev. 1994; 3: 261-269
- Quality improvement in primary care clinics.Jt Comm J Qual Improv. 1998; 24: 361-370
- Healthcare performance measurement. American Society for Quality, Chicago1999
- Strategic alliances as structure for integrated delivery systems.in: Kaluzny A.D Zuckerman H.S Ricketts T.C Partners for the dance forming strategic alliances in health care. Health Administration Press, Ann Arbor, MI1995
- An organizational field approach to resource environments in healthcare.Health Serv Res. 1998; 32: 775-803
- The organization of medical care services.Med Care Rev. 1993; 50: 271-303
- Predicting the performance of a strategic alliance.Health Serv Res. 1993; 28: 159-182
- Statistical methods for the analysis of biomedical data. Wiley, New York1987
- Using continuous quality improvement to increase preventive services in clinical practice—going beyond guidelines.Prev Med. 1996; 25: 259-267
Article info
Identification
Copyright
© 2000 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
