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An implementation science approach to the systematic study of access to gynecologic cancer care.
Shalowitz, David I; Schroeder, Mary C; Birken, Sarah A.
Afiliación
  • Shalowitz DI; West Michigan Cancer Center, Kalamazoo, MI, United States of America; Collaborative on Equity in Rural Cancer Care, Kalamazoo, MI, United States of America. Electronic address: david.shalowitz@gmail.com.
  • Schroeder MC; Collaborative on Equity in Rural Cancer Care, Kalamazoo, MI, United States of America; Division of Health Services Research, College of Pharmacy, University of Iowa, Iowa City, IA, United States of America.
  • Birken SA; Collaborative on Equity in Rural Cancer Care, Kalamazoo, MI, United States of America; Department of Implementation Science, School of Medicine, Wake Forest University, Winston-Salem, USA.
Gynecol Oncol ; 172: 78-81, 2023 05.
Article en En | MEDLINE | ID: mdl-36972637
ABSTRACT

INTRODUCTION:

Barriers to access to cancer care are profoundly threatening to patients with gynecologic malignancies. Implementation science focuses on empirical investigation of factors influencing delivery of clinical best practices, as well as interventions designed to improve delivery of evidence-based care. We outline one prominent framework for conducting implementation research and discuss its application to improving access to gynecologic cancer care.

METHODS:

Literature on the use of the Consolidated Framework for Implementation Research (CFIR) was reviewed. Delivery of cytoreductive surgery for advanced ovarian carcinoma was selected as an illustrative case of an evidence-based intervention (EBI) in gynecologic oncology. CFIR domains were applied to the context of cytoreductive surgical care, highlighting examples of empirically-assessable determinants of care delivery.

RESULTS:

CFIR domains include Innovation, Inner Setting, Outer Setting, Individuals, and Implementation Process. "Innovation" relates to characteristics of the surgical intervention itself; "Inner Setting" relates to the environment in which surgery is delivered. "Outer Setting" refers to the broader care environment influencing the Inner Setting. "Individuals" highlights attributes of persons directly involved in care delivery, and "Implementation Process" focuses on integration of the Innovation within the Inner Setting.

CONCLUSIONS:

Prioritization of implementation science methods in the study of access to gynecologic cancer care will help ensure that patients are able to utilize interventions with the greatest prospect of benefiting them.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Neoplasias de los Genitales Femeninos Tipo de estudio: Guideline / Qualitative_research / Sysrev_observational_studies Aspecto: Equity_inequality / Implementation_research Límite: Female / Humans Idioma: En Revista: Gynecol Oncol Año: 2023 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Atención Primaria de Salud / Neoplasias de los Genitales Femeninos Tipo de estudio: Guideline / Qualitative_research / Sysrev_observational_studies Aspecto: Equity_inequality / Implementation_research Límite: Female / Humans Idioma: En Revista: Gynecol Oncol Año: 2023 Tipo del documento: Article