--- title: "Integrating cancer screen pt decision spt in practice. | Sutter Health" description: "Use DESIs immediately before a consultation if the practice can provide basic accommodation and value pt care goals." url: "https://www.sutterhealth.org/research/publications/integrate-cancer-screen-pt-decision-spt-1055312534" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Integrating cancer screen pt decision spt in practice. # Conducting implementation research in community-based primary care: a qualitative study on integrating patient decision support interventions for cancer screening into routine practice. Frosch DL, Singer KJ, & Timmermans S. _Health Expect. 14 suppl 1:73-84. doi: 10.1111/j.1369-7625.2009.00579.x._ 2011-03-01 ## Abstract BACKGROUND: Despite a growing body of evidence supporting the efficacy of patient decision support interventions (DESI), little is known about their implementation in community-based primary care practices. OBJECTIVE: The goal of this study was to explore the feasibility of integrating the use of DESIs for cancer screening in primary care practices serving patients from diverse backgrounds and learn more about the potential barriers and facilitators of integration. SETTING: 12 community-based primary care practices in metropolitan Los Angeles. MAIN VARIABLES STUDIED: Qualitative field notes documented the roles played by staff and physicians in accomplishing project goals, the impact of the programs on the clinical workflow in the practices and other noteworthy observations. RESULTS: Practices that were better able to integrate the project had adequate clinic infrastructure, a relatively well-matched patient pool, and positive work and patient care environments. The remaining identified components, including staff facilitation and the physician's role accounted for higher level differences between the clinics, acting as barriers and facilitators that distinguished practices that were able to work independently from those that required more assistance and, to a lesser extent, those clinics that did and those that did not meet the project goals. DISCUSSION AND CONCLUSIONS: This study suggests that implementation of DESIs to be used immediately before a consultation is feasible if the practice infrastructure can provide sufficient basic accommodation and physician and staff are dedicated to patient care goals that are implicit in the use of these tools. Overall, the physician's role appeared to be the most important factor in determining whether project integration was successful. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/19906215) ## Research topics - [All Cancer](https://www.sutterhealth.org/research-search-results?query=%22%5C%22All+Cancer%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [The importance of integrating narrative into health care decision making.](https://www.sutterhealth.org/research/publications/integrate-narrative-in-healthcare-decision-making-1055312429) Dohan D, Garrett SB, Rendle KA, Halley M, Abramson C. Health Aff (Millwood). 35(4):720-5. doi: 10.1377/hlthaff.2015.1373. 2016 Apr 01 - Publication ### [Predicting prostate cancer treatment choices: The role of numeracy, time discounting, and risk attitudes.](https://www.sutterhealth.org/research/publications/predicting-prostate-cancer-treatment-choices-1055312355) López-Pérez B, Barnes A, Frosch DL, Hanoch Y. J Health Psychol. 22(6):788-797. doi: 10.1177/1359105315615931. Epub 2015 Nov 26. 2017 May 01 - Publication ### [Chemoprevention: risk reduction with medical therapy of inflammatory bowel disease.](https://www.sutterhealth.org/research/publications/crc-risk-reduction-med-therapy-ibd-1055312878) Chan EP, Lichtenstein GR. Gastroenterol Clin North Am. 35(3):675-712. 2006 Sep 01 - Publication ### [Improved targeting accuracy of lung tumor biopsies with scanning-beam digital x-ray tomosynthesis image guidance.](https://www.sutterhealth.org/research/publications/lung-cancer-bx-x-ray-tomosynthesis-image-guidance-1055312495) Nelson G, Wu M, Hinkel C, Krishna G, Funk T, Rosenberg J, Fahrig R. Med Phys. 43(12):6282. 2016 Dec 01 - Publication ### [Evolving goals of care discussions as described in interviews with individuals with advanced cancer and oncology and palliative care teams.](https://www.sutterhealth.org/research/publications/goals-of-care-discussions-in-advanced-cancer-1055312861) Dillon EC, Meehan A, Nasrallah C, Lai S, Colocci N, Luft H. Am J Hosp Palliat Care. 1049909120969202. doi: 10.1177/1049909120969202. Online ahead of print. 2020 Oct 28 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/integrate-cancer-screen-pt-decision-spt-1055312534#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Integrating cancer screen pt decision spt in practice."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/integrate-cancer-screen-pt-decision-spt-1055312534#medicalscholarlyarticle","name":"Conducting implementation research in community-based primary care: a qualitative study on integrating patient decision support interventions for cancer screening into routine practice.","headline":"Integrating cancer screen pt decision spt in practice.","abstract":"BACKGROUND: Despite a growing body of evidence supporting the efficacy of patient decision support interventions (DESI), little is known about their implementation in community-based primary care practices. OBJECTIVE: The goal of this study was to explore the feasibility of integrating the use of DESIs for cancer screening in primary care practices serving patients from diverse backgrounds and learn more about the potential barriers and facilitators of integration. SETTING: 12 community-based primary care practices in metropolitan Los Angeles. MAIN VARIABLES STUDIED: Qualitative field notes documented the roles played by staff and physicians in accomplishing project goals, the impact of the programs on the clinical workflow in the practices and other noteworthy observations. RESULTS: Practices that were better able to integrate the project had adequate clinic infrastructure, a relatively well-matched patient pool, and positive work and patient care environments. The remaining identified components, including staff facilitation and the physician's role accounted for higher level differences between the clinics, acting as barriers and facilitators that distinguished practices that were able to work independently from those that required more assistance and, to a lesser extent, those clinics that did and those that did not meet the project goals. DISCUSSION AND CONCLUSIONS: This study suggests that implementation of DESIs to be used immediately before a consultation is feasible if the practice infrastructure can provide sufficient basic accommodation and physician and staff are dedicated to patient care goals that are implicit in the use of these tools. 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