TY - JOUR
T1 - Assessing local capacity to expand rural breast cancer screening and patient navigation
T2 - An iterative mixed-method tool
AU - Inrig, Stephen J.
AU - Higashi, Robin T.
AU - Tiro, Jasmin A.
AU - Argenbright, Keith E.
AU - Lee, Simon J Craddock
N1 - Funding Information:
Evaluation and analysis was supported by an award from the Cancer Prevention Research Institute of Texas (PP120097), which underwrote the BSPAN clinical screening and navigation program. Additional support was provided by the NIH (5P30CA142543) to the Harold C. Simmons Comprehensive Cancer Center, and (CATS UL1TR001105) to the UT Southwestern Center for Translational Medicine for REDCap data collection, Paul A. Harris, Robert Taylor, Robert Thielke, Jonathon Payne, Nathaniel Gonzalez, Jose G. Conde, Research electronic data capture (REDCap) ? A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform. 2009 Apr;42(2):377-81. Drs. Lee and Tiro are also supported by funding from the Agency for Healthcare Research and Quality (R24 HS022418) to the UT Southwestern Center for Patient-Centered Outcomes Research.
Publisher Copyright:
© 2016 Elsevier Ltd
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. Methods Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. Results Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. Conclusions Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.
AB - Background Despite federal funding for breast cancer screening, fragmented infrastructure and limited organizational capacity hinder access to the full continuum of breast cancer screening and clinical follow-up procedures among rural-residing women. We proposed a regional hub-and-spoke model, partnering with local providers to expand access across North Texas. We describe development and application of an iterative, mixed-method tool to assess county capacity to conduct community outreach and/or patient navigation in a partnership model. Methods Our tool combined publicly-available quantitative data with qualitative assessments during site visits and semi-structured interviews. Results Application of our tool resulted in shifts in capacity designation in 10 of 17 county partners: 8 implemented local outreach with hub navigation; 9 relied on the hub for both outreach and navigation. Key factors influencing capacity: (1) formal linkages between partner organizations; (2) inter-organizational relationships; (3) existing clinical service protocols; (4) underserved populations. Qualitative data elucidate how our tool captured these capacity changes. Conclusions Our capacity assessment tool enabled the hub to establish partnerships with county organizations by tailoring support to local capacity and needs. Absent a vertically integrated provider network for preventive services in these rural counties, our tool facilitated a virtually integrated regional network to extend access to breast cancer screening to underserved women.
KW - Access to care
KW - Breast cancer screening
KW - Evaluation design and research
KW - Service capacity
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U2 - 10.1016/j.evalprogplan.2016.11.006
DO - 10.1016/j.evalprogplan.2016.11.006
M3 - Article
C2 - 28011433
AN - SCOPUS:85006802481
SN - 0149-7189
VL - 61
SP - 113
EP - 124
JO - Evaluation and Program Planning
JF - Evaluation and Program Planning
ER -