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dc.contributor.authorMilton, Shakira
dc.contributor.authorEmery, Jon D
dc.contributor.authorRinaldi, Jane
dc.contributor.authorKinder, Joanne
dc.contributor.authorBickerstaffe, Adrian
dc.contributor.authorSaya, Sibel
dc.contributor.authorJenkins, Mark A
dc.contributor.authorMcIntosh, Jennifer
dc.description.abstractBACKGROUND: We developed a colorectal cancer risk prediction tool ('CRISP') to provide individualised risk-based advice for colorectal cancer screening. Using known environmental, behavioural, and familial risk factors, CRISP was designed to facilitate tailored screening advice to patients aged 50 to 74 years in general practice. In parallel to a randomised controlled trial of the CRISP tool, we developed and evaluated an evidence-based implementation strategy. METHODS: Qualitative methods were used to explore the implementation of CRISP in general practice. Using one general practice in regional Victoria, Australia, as a 'laboratory', we tested ways to embed CRISP into routine clinical practice. General practitioners, nurses, and operations manager co-designed the implementation methods with researchers, focussing on existing practice processes that would be sustainable. Researchers interviewed the staff regularly to assess the successfulness of the strategies employed, and implementation methods were adapted throughout the study period in response to feedback from qualitative interviews. The Consolidated Framework for Implementation Research (CFIR) underpinned the development of the interview guide and intervention strategy. Coding was inductive and themes were developed through consensus between the authors. Emerging themes were mapped onto the CFIR domains and a fidelity checklist was developed to ensure CRISP was being used as intended. RESULTS: Between December 2016 and September 2019, 1 interviews were conducted, both face-to-face and via videoconferencing (Zoom). All interviews were transcribed verbatim and coded. Themes were mapped onto the following CFIR domains: (1) 'characteristics of the intervention': CRISP was valued but time consuming; (2) 'inner setting': the practice was open to changing systems; 3. 'outer setting': CRISP helped facilitate screening; (4) 'individual characteristics': the practice staff were adaptable and able to facilitate adoption of new clinical processes; and (5) 'processes': fidelity checking, and education was important. CONCLUSIONS: These results describe a novel method for exploring implementation strategies for a colorectal cancer risk prediction tool in the context of a parallel RCT testing clinical efficacy. The study identified successful and unsuccessful implementation strategies using an adaptive methodology over time. This method emphasised the importance of co-design input to make an intervention like CRISP sustainable for use in other practices and with other risk tools.
dc.publisherSpringer Science and Business Media LLC
dc.rightsAttribution 4.0 International
dc.sourcenlmid: 101258411
dc.sourceessn: 1748-5908
dc.subjectGeneral Practice
dc.subjectPrimary Care
dc.subjectColorectal Cancer Screening
dc.subjectImplementation Science
dc.subjectRisk Prediction Tool
dc.subjectColorectal Neoplasms
dc.subjectQualitative Research
dc.subjectPrimary Health Care
dc.subjectGeneral Practitioners
dc.titleExploring a novel method for optimising the implementation of a colorectal cancer risk prediction tool into primary care: a qualitative study.
prism.publicationNameImplement Sci
dc.contributor.orcidMilton, Shakira [0000-0002-8510-6351]
pubs.funder-project-idVictorian Cancer Agency (HSR15019)
pubs.funder-project-idNational Health and Medical Research Council (1195302, 1042021, 1195099)
pubs.funder-project-idAustralian Research Council (FL190100035)

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Attribution 4.0 International
Except where otherwise noted, this item's licence is described as Attribution 4.0 International