Karen E Dyer1, Deirdre A Shires2, Susan A Flocke3, Sarah T Hawley4, Resa M Jones5, Ken Resnicow6, Yongyun Shin7, Jennifer Elston Lafata8. 1. VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, California. Electronic address: karen.dyer@va.gov. 2. School of Social Work, Michigan State University, East Lansing, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan. 3. Center for Community Health Integration, Case Western Reserve University, Cleveland, Ohio. 4. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan; University of Michigan School of Public Health, Ann Arbor, Michigan; VA Center for Clinical Management Research, Ann Arbor, Michigan. 5. Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Philadelphia, Pennsylvania; Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania. 6. University of Michigan School of Public Health, Ann Arbor, Michigan; University of Michigan Rogel Cancer Center, Ann Arbor, Michigan. 7. Department of Biostatistics, Virginia Commonwealth University, Richmond, Virginia. 8. Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan; UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina; UNC Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
Abstract
INTRODUCTION: Patient-physician communication about colorectal cancer screening can affect screening use, but discussions often lack information that patients need for informed decision making and seldom address personal preferences or barriers. To address this gap, a series of patient focus groups was conducted to guide the development of an online, interactive decision support program. This article presents findings on patient information needs and barriers to colorectal cancer screening after receiving a screening recommendation from a physician, and their perspectives on using electronic patient portals as platforms for health-related decision support. METHODS: Primary care patients with recent colonoscopy or stool testing orders were identified via the centralized data repository of a large Midwestern health system. Seven gender-stratified focus groups (N=45 participants) were convened between April and July 2016. Sessions were audio recorded, transcribed, coded, and analyzed for commonly expressed themes beginning in August 2016. RESULTS: Findings reveal a consistent need for simple and clear information on colorectal cancer screening. Participants desired step-by-step explanations of the colonoscopy procedure and information about bowel preparation options/alternatives. The desired level of additional information varied: some patients wanted to know about and act on test options, whereas others preferred following their physician-recommended testing path. Fears and concerns were prevalent, particularly about colonoscopy, and patients reported challenges getting these concerns and their informational needs addressed. Finally, they expressed consistent support for using the patient portal to gather additional information from their physician. CONCLUSIONS: Patient portals may offer an opportunity to build sustainable programs for decision support and assistance that are integrated with clinic workflows and processes. Published by Elsevier Inc.
INTRODUCTION:Patient-physician communication about colorectal cancer screening can affect screening use, but discussions often lack information that patients need for informed decision making and seldom address personal preferences or barriers. To address this gap, a series of patient focus groups was conducted to guide the development of an online, interactive decision support program. This article presents findings on patient information needs and barriers to colorectal cancer screening after receiving a screening recommendation from a physician, and their perspectives on using electronic patient portals as platforms for health-related decision support. METHODS: Primary care patients with recent colonoscopy or stool testing orders were identified via the centralized data repository of a large Midwestern health system. Seven gender-stratified focus groups (N=45 participants) were convened between April and July 2016. Sessions were audio recorded, transcribed, coded, and analyzed for commonly expressed themes beginning in August 2016. RESULTS: Findings reveal a consistent need for simple and clear information on colorectal cancer screening. Participants desired step-by-step explanations of the colonoscopy procedure and information about bowel preparation options/alternatives. The desired level of additional information varied: some patients wanted to know about and act on test options, whereas others preferred following their physician-recommended testing path. Fears and concerns were prevalent, particularly about colonoscopy, and patients reported challenges getting these concerns and their informational needs addressed. Finally, they expressed consistent support for using the patient portal to gather additional information from their physician. CONCLUSIONS:Patient portals may offer an opportunity to build sustainable programs for decision support and assistance that are integrated with clinic workflows and processes. Published by Elsevier Inc.
Authors: Donald Steinwachs; Jennifer Dacey Allen; William Eric Barlow; R Paul Duncan; Leonard E Egede; Lawrence S Friedman; Nancy L Keating; Paula Kim; Judith R Lave; Thomas A Laveist; Roberta B Ness; Robert J Optican; Beth A Virnig Journal: Ann Intern Med Date: 2010-04-13 Impact factor: 25.391
Authors: Jennifer Elston Lafata; Gregory S Cooper; George Divine; Susan A Flocke; Nancy Oja-Tebbe; Kurt C Stange; Tracy Wunderlich Journal: Am J Prev Med Date: 2011-11 Impact factor: 5.043
Authors: Steven H Woolf; Alex H Krist; Jennifer Elston Lafata; Resa M Jones; Rebecca R Lehman; Camille J Hochheimer; Roy T Sabo; Dominick L Frosch; Brian J Zikmund-Fisher; Daniel R Longo Journal: Am J Prev Med Date: 2017-12-11 Impact factor: 5.043
Authors: Sue Peacock; Ashok Reddy; Suzanne G Leveille; Jan Walker; Thomas H Payne; Natalia V Oster; Joann G Elmore Journal: J Am Med Inform Assoc Date: 2017-04-01 Impact factor: 4.497
Authors: Amir Alishahi Tabriz; Susan A Flocke; Deirdre Shires; Karen E Dyer; Michelle Schreiber; Jennifer Elston Lafata Journal: BMJ Qual Saf Date: 2019-12-11 Impact factor: 7.035