Heather M Hanson1,2, Patricia Harasym3, Angela G Juby4, Paul Kivi4, Lauren A Beaupre5,6, Sumit R Majumdar4,7. 1. Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, 3D10T2N 4Z6, Canada. heather.hanson@ahs.ca. 2. Provincial Seniors Health and Continuing Care, Alberta Health Services, 10301 Southport Lane SW, Calgary, AB, T2W 1S7, Canada. heather.hanson@ahs.ca. 3. Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, 3D10T2N 4Z6, Canada. 4. Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada. 5. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, 8205 114 St. NW, Edmonton, AB, T6G 2G4, Canada. 6. Department of Orthopedics, Faculty of Medicine, University of Alberta, 2J2.00 WC Mackenzie Health Sciences Centre, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada. 7. School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405 - 87 Ave NW, Edmonton, AB, T6G 1C9, Canada.
Abstract
Catch a Break staff conducting the organizational work of delivering secondary fracture prevention screening conversations drew on cultural and organizational resources to determine eligibility of individuals. They encountered and navigated their way through interactional troubles as they requested participation, assessed trauma risk, and provided lifestyle information. PURPOSE: We investigated delivery of a population-based type C fracture liaison service for non-hip fractures. The purpose of this study was to examine accounts of how osteoporosis health risk screening interactions were delivered. METHODS: A pre-determined sample of 5 organizational representatives (program staff) were interviewed by telephone. We analyzed the qualitative data through the lens of interpretive inquiry, informed by discourse analysis, to examine staff's "talk" about conducting the program risk screening conversations. RESULTS: A dominant finding emerging from CAB staff's accounts of program delivery was the conversational work required to include only those individuals deemed appropriate for the program while managing the survey interaction. Staff talked about specific examples of interactional troubles they experienced as barriers to the smooth and successful risk screening conversation. They drew on cultural and organizational resources as interpretive frameworks to make decisions about individuals and groups at risk and in need of further investigation. They drew on larger ideas about ageism and genderism, judging as inappropriate for participation the oldest old adults, men involved in high risk occupations, and adults aged 50 to 70. Staff also employed interactional resources useful in managing problems in the conversation during the request to participate, trauma risk assessment, and lifestyle/health information provision sequences of the risk screening call. CONCLUSION: We uncovered areas in the screening interaction that were talked about by staff as problematic to achieving the program objective of identifying and enrolling individuals in the secondary fracture prevention program. By highlighting areas for improvement in program delivery, this study may help to reduce the interactional troubles staff negotiate as they deliver this type of program.
Catch a Break staff conducting the organizational work of delivering secondary fracture prevention screening conversations drew on cultural and organizational resources to determine eligibility of individuals. They encountered and navigated their way through interactional troubles as they requested participation, assessed trauma risk, and provided lifestyle information. PURPOSE: We investigated delivery of a population-based type C fracture liaison service for non-hip fractures. The purpose of this study was to examine accounts of how osteoporosis health risk screening interactions were delivered. METHODS: A pre-determined sample of 5 organizational representatives (program staff) were interviewed by telephone. We analyzed the qualitative data through the lens of interpretive inquiry, informed by discourse analysis, to examine staff's "talk" about conducting the program risk screening conversations. RESULTS: A dominant finding emerging from CAB staff's accounts of program delivery was the conversational work required to include only those individuals deemed appropriate for the program while managing the survey interaction. Staff talked about specific examples of interactional troubles they experienced as barriers to the smooth and successful risk screening conversation. They drew on cultural and organizational resources as interpretive frameworks to make decisions about individuals and groups at risk and in need of further investigation. They drew on larger ideas about ageism and genderism, judging as inappropriate for participation the oldest old adults, men involved in high risk occupations, and adults aged 50 to 70. Staff also employed interactional resources useful in managing problems in the conversation during the request to participate, trauma risk assessment, and lifestyle/health information provision sequences of the risk screening call. CONCLUSION: We uncovered areas in the screening interaction that were talked about by staff as problematic to achieving the program objective of identifying and enrolling individuals in the secondary fracture prevention program. By highlighting areas for improvement in program delivery, this study may help to reduce the interactional troubles staff negotiate as they deliver this type of program.
Authors: Niamh M Redmond; Sandra Hollinghurst; Céire Costelloe; Alan A Montgomery; Margaret Fletcher; Tim J Peters; Alastair D Hay Journal: Clin Trials Date: 2013-08 Impact factor: 2.486