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Adoption of a health education intervention for family members of breast cancer patients

  • Paul K Halverson
    Affiliations
    Department of Health Policy and Administration, School of Public Health, University of North Carolina (Halverson), Chapel Hill, North Carolina, USA

    Public Health Practice Program Office, Centers for Disease Control and Prevention (Halverson), Atlanta, Georgia, USA
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  • Glen P Mays
    Correspondence
    Address correspondence and reprint requests to: Glen P. Mays, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Drive, Boston, MA 02115
    Affiliations
    Department of Health Policy and Administration, School of Public Health, University of North Carolina (Halverson), Chapel Hill, North Carolina, USA

    Department of Health Care Policy, Harvard Medical School (Mays), Boston, Massachusetts, USA
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  • Barbara K Rimer
    Affiliations
    Division of Cancer Control and Population Sciences, National Cancer Institute (Rimer), Rockville, Maryland, USA
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  • Caryn Lerman
    Affiliations
    Lombardi Cancer Center, Georgetown University Medical Center (Lerman and Audrain), Washington DC, USA
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  • Janet Audrain
    Affiliations
    Lombardi Cancer Center, Georgetown University Medical Center (Lerman and Audrain), Washington DC, USA
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  • Arnold D Kaluzny
    Affiliations
    Department of Health Policy and Administration, School of Public Health, University of North Carolina (Halverson), Chapel Hill, North Carolina, USA

    School of Public Health, Cecil G. Sheps Center for Health Services Research Chapel Hill, North Carolina, USA

    Lineberger Comprehensive Cancer Center, University of North Carolina (Kaluzny), Chapel Hill, North Carolina, USA
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      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

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