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Published in: Journal of Immigrant and Minority Health 5/2013

01-10-2013 | Original Paper

Cancer Screening at a Federally Qualified Health Center: A Qualitative Study on Organizational Challenges in the Era of the Patient-Centered Medical Home

Authors: Javiera Martinez-Gutierrez, Esther Jhingan, Antoinette Angulo, Ricardo Jimenez, Beti Thompson, Gloria D. Coronado

Published in: Journal of Immigrant and Minority Health | Issue 5/2013

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Abstract

Federally Qualified Health Centers (FQHCs) serve uninsured and minority populations, who have low cancer screening rates. The patient-centered medical home (PCMH) model aims to provide comprehensive preventive services, including cancer screening, to these populations. Little is known about organizational factors influencing the delivery of cancer screening in this context. We conducted 18 semi-structured interviews with clinic personnel at four FQHC clinics in Washington State. All interviews were recorded and transcribed verbatim and analyzed by two bilingual coders to identify salient themes. We found that screening on-site, scheduling separate visits for preventive care, and having non-provider staff recommend and schedule screening services facilitated the delivery of cancer screening. We found work overload to be a barrier to screening. To successfully implement screening strategies within the PCMH model, FQHCs must enhance facilitators and address organizational gaps in their cancer screening processes.
Literature
2.
go back to reference Axelroda DA, Millman D, Abecassis MM. US health care reform and transplantation, part II: impact on the public sector and novel health care delivery systems. Am J Transpl. 2010;10:2203–7.CrossRef Axelroda DA, Millman D, Abecassis MM. US health care reform and transplantation, part II: impact on the public sector and novel health care delivery systems. Am J Transpl. 2010;10:2203–7.CrossRef
4.
go back to reference Starfield B, Shi L. The medical home, access to care, and insurance: a review of evidence. Pediatrics. 2004;113:1493–8. Starfield B, Shi L. The medical home, access to care, and insurance: a review of evidence. Pediatrics. 2004;113:1493–8.
5.
go back to reference Reid RJ, Larson EB. Financial implications of the patient-centered medical home. JAMA. 2012;24:1–2. Reid RJ, Larson EB. Financial implications of the patient-centered medical home. JAMA. 2012;24:1–2.
6.
go back to reference Nuño T, Castle PE, Harris R, Estrada A, Garcia F. Breast and cervical cancer screening utilization among Hispanic women living near the United States–Mexico border. J Women’s Health. 2011;20(5):685–93.CrossRef Nuño T, Castle PE, Harris R, Estrada A, Garcia F. Breast and cervical cancer screening utilization among Hispanic women living near the United States–Mexico border. J Women’s Health. 2011;20(5):685–93.CrossRef
7.
go back to reference Byrd TL, Chavez R, Wilson KM. Barriers and facilitators of cervical cancer screening among Hispanic women. Ethn Dis. 2007;17(1):129–34.PubMed Byrd TL, Chavez R, Wilson KM. Barriers and facilitators of cervical cancer screening among Hispanic women. Ethn Dis. 2007;17(1):129–34.PubMed
8.
go back to reference Yang TC, Matthews SA, Hillemeier MM. Effect of health care system distrust on breast and cervical cancer screening in Philadelphia, Pennsylvania. Am J Public Health. 2011;101(7):1297–305.PubMedCrossRef Yang TC, Matthews SA, Hillemeier MM. Effect of health care system distrust on breast and cervical cancer screening in Philadelphia, Pennsylvania. Am J Public Health. 2011;101(7):1297–305.PubMedCrossRef
9.
go back to reference Stone EG, Morton SC, Hulscher ME, et al. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Int Med. 2002;136(9):641–51.PubMedCrossRef Stone EG, Morton SC, Hulscher ME, et al. Interventions that increase use of adult immunization and cancer screening services: a meta-analysis. Ann Int Med. 2002;136(9):641–51.PubMedCrossRef
10.
go back to reference Anhang Price R, Zapka J. Heather Edwards, organizational factors and the cancer screening process. J Natl Cancer Inst Monogr. 2010;40:38–57.CrossRef Anhang Price R, Zapka J. Heather Edwards, organizational factors and the cancer screening process. J Natl Cancer Inst Monogr. 2010;40:38–57.CrossRef
11.
go back to reference Arroyave AM, Penaranda EK, Lewis CL. Organizational change: a way to increase colon, breast and cervical cancer screening in primary care practices. J Community Health. 2011;36:281–8.PubMedCrossRef Arroyave AM, Penaranda EK, Lewis CL. Organizational change: a way to increase colon, breast and cervical cancer screening in primary care practices. J Community Health. 2011;36:281–8.PubMedCrossRef
13.
go back to reference Lehman WE, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22:197–209.PubMedCrossRef Lehman WE, Greener JM, Simpson DD. Assessing organizational readiness for change. J Subst Abuse Treat. 2002;22:197–209.PubMedCrossRef
14.
go back to reference Armenakis A, Bernerth JB, Pitts JP, et al. Organizational change recipients’ beliefs scale: development of an assessment instrument. J Appl Behav Sci. 2007;43:481–505.CrossRef Armenakis A, Bernerth JB, Pitts JP, et al. Organizational change recipients’ beliefs scale: development of an assessment instrument. J Appl Behav Sci. 2007;43:481–505.CrossRef
15.
go back to reference Rittenhouse DR, Shortell SM. The patient-centered medical home: will it stand the test of health reform? JAMA. 2009;301(19):2038–40.PubMedCrossRef Rittenhouse DR, Shortell SM. The patient-centered medical home: will it stand the test of health reform? JAMA. 2009;301(19):2038–40.PubMedCrossRef
16.
go back to reference Nocon RS, Sharma R, Birnberg JM, Ngo-Metzger Q, Lee SM, Chin MH. Association between patient-centered medical home rating and operating cost at federally funded health centers patient-centered medical home rating and operating cost. JAMA. 2012;24:1–7. Nocon RS, Sharma R, Birnberg JM, Ngo-Metzger Q, Lee SM, Chin MH. Association between patient-centered medical home rating and operating cost at federally funded health centers patient-centered medical home rating and operating cost. JAMA. 2012;24:1–7.
17.
go back to reference Larson EB, Reid R. The patient-centered medical home movement: why now? JAMA. 2010;303(16):1644–5.PubMedCrossRef Larson EB, Reid R. The patient-centered medical home movement: why now? JAMA. 2010;303(16):1644–5.PubMedCrossRef
19.
22.
go back to reference Flodgren G, Eccles MP, Shepperd S, Scott A, Parmelli E, Beyer FR. An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. Cochrane Database Syst Rev. 2011;6(7):CD009255. Flodgren G, Eccles MP, Shepperd S, Scott A, Parmelli E, Beyer FR. An overview of reviews evaluating the effectiveness of financial incentives in changing healthcare professional behaviours and patient outcomes. Cochrane Database Syst Rev. 2011;6(7):CD009255.
23.
go back to reference Scott A, Sivey P, Ait Ouakrim D, Willenberg L, Naccarella L, Furler J, Young D. The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane Database Syst Rev. 2011; 7(9):CD008451. Review. Cochrane Database Syst Rev. 2011; 6(7):CD009255. Scott A, Sivey P, Ait Ouakrim D, Willenberg L, Naccarella L, Furler J, Young D. The effect of financial incentives on the quality of health care provided by primary care physicians. Cochrane Database Syst Rev. 2011; 7(9):CD008451. Review. Cochrane Database Syst Rev. 2011; 6(7):CD009255.
Metadata
Title
Cancer Screening at a Federally Qualified Health Center: A Qualitative Study on Organizational Challenges in the Era of the Patient-Centered Medical Home
Authors
Javiera Martinez-Gutierrez
Esther Jhingan
Antoinette Angulo
Ricardo Jimenez
Beti Thompson
Gloria D. Coronado
Publication date
01-10-2013
Publisher
Springer US
Published in
Journal of Immigrant and Minority Health / Issue 5/2013
Print ISSN: 1557-1912
Electronic ISSN: 1557-1920
DOI
https://doi.org/10.1007/s10903-012-9701-8

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