PO.CL04.02 · 临床研究
采用多方法途径在联邦合格医疗中心内开发和优化戒烟工作流程
Using multi-method approaches to develop and refine a tobacco cessation workflow within a Federally Qualified Health Center
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摘要 Abstract
中文摘要
背景：将实施科学方法纳入烟草控制项目实施的做法仍然有限。使用这些方法（包括共同创建）开发的项目通常更具可行性和可持续性，因为它们的设计考虑了组织的运营和文化背景。本研究利用多种实施科学方法，在一家联邦合格医疗中心（FQHC）内共同创建戒烟工作流程，该中心的烟草使用率明显高于全国平均水平。
方法：在本研究中，我们于2025年7月至9月期间在两个咨询小组中开展了六次结构化会议。整合了多种实施科学方法（即形式与功能、脑写事前剖析（brainwriting premortem）以及实用、稳健的实施与可持续性模型（PRISM）评估）以优化戒烟工作流程，并结合共同创建和评估方法（即人种学观察、参与度调查）来评估咨询委员会的参与度。同时收集并分析了定性和定量数据，使用快速定性分析和描述性统计，从而实现对结果的全面理解和迭代整合。
结果：十三名个体作为共同创建伙伴参与了本研究，年龄介于27至69岁之间（M=31）。参与者代表FQHC内的各种角色，包括一线员工、行政人员、医疗提供者和患者。工作流程优化：参与者在优化戒烟工作流程时识别出5个核心功能和16种形式。脑写事前剖析在PRISM各背景领域内产生了29个独特的失败点和19个解决方案，其中16个被整合。共同创建工作流程的最终版本具有高接受度（M=4.8）、适宜性（M=4.6）和可行性（M=4.5）。参与者参与度：各次会议共识别出394次互动。最常见的互动是提供信息（53%），其次是寻求信息（18%）。咨询委员会参与的质量和频率获得了良好评价（平均4.7分，满分5分）。对开放式回答的快速定性分析凸显了共同创建的价值，参与者表示：“我很高兴参与了这个咨询小组……并且我能够把[这些信息]带回我的团队，以帮助我们的患者。”
结论：本研究凸显了如何通过多种实施科学方法进行共同创建，用于构思、调整和优化能够响应FQHC需求的项目。
查看英文原文 English abstract
Background: The incorporation of implementation science approaches into tobacco control program delivery remains limited. Programs developed using these approaches, including co-creation, are often more feasible and sustainable, as they are designed to consider the operational and cultural context of an organization. This study utilized multiple implementation science approaches to co-create a tobacco cessation workflow within a Federally Qualified Health Center, where tobacco use is disproportionately higher than the national average.
Methods: In this study we conducted six structured meetings across two advisory groups between July-September 2025. Multiple implementation science methods (i.e., forms and functions, brainwriting premortem, and Practical, Robust Implementation and Sustainability Model (PRISM) assessments) were integrated to optimize the tobacco cessation workflow along with co-creation and evaluation methods (i.e., ethnographic observations, engagement survey) to evaluate advisory board engagement. Qualitative and quantitative data were collected and analyzed simultaneously using rapid qualitative analysis and descriptive statistics allowing for a comprehensive understanding and iterative incorporation of the results.
Results: Thirteen individuals participated in this study as co-creation partners who were between the ages 27 to 69 years (M = 31). Participants represent various roles within the FQHC including front-line staff, administrators, providers, and patients. Workflow Optimization: Participants identified 5 core functions and 16 forms in the refinement of the tobacco cessation workflow. Brainwriting Premortem resulted in 29 unique failures and 19 solutions within the workflow across PRISM contextual domains, of which 16 were integrated. The final version of the co-created workflow had high acceptability (M=4.8), appropriateness (M=4.6), and feasibility (M=4.5).
Participant Engagement: A total of 394 interactions were identified across meetings. The most frequent interaction was giving information (53%), followed by seeking information (18%). The quality and frequency of advisory board engagement was rated favorably (average 4.7 of 5). Rapid qualitative analysis of open-ended responses highlighted the value of co-creation with participants stating: “I am glad I participated in this advisory panel... and I am able to bring [this information] back to my team to help our patients.”
Conclusion: This study highlights how co-creation through multiple implementation science methods can be used to conceptualize, adapt, and refine programs responsive to FQHC needs.
利益披露 Disclosure
L. Salgin, None..
J. P. Calzo, None..
J. K. Felner, None..
D. Strong, None..
M. Seifert, None..
B. A. Rabin, None.