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Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.

Publication ,  Journal Article
Sperber, NR; Andrews, SM; Voils, CI; Green, GL; Provenzale, D; Knight, S
Published in: J Pers Med
April 28, 2016

We examined facilitators and barriers to adoption of genomic services for colorectal care, one of the first genomic medicine applications, within the Veterans Health Administration to shed light on areas for practice change. We conducted semi-structured interviews with 58 clinicians to understand use of the following genomic services for colorectal care: family health history documentation, molecular and genetic testing, and genetic counseling. Data collection and analysis were informed by two conceptual frameworks, the Greenhalgh Diffusion of Innovation and Andersen Behavioral Model, to allow for concurrent examination of both access and innovation factors. Specialists were more likely than primary care clinicians to obtain family history to investigate hereditary colorectal cancer (CRC), but with limited detail; clinicians suggested templates to facilitate retrieval and documentation of family history according to guidelines. Clinicians identified advantage of molecular tumor analysis prior to genetic testing, but tumor testing was infrequently used due to perceived low disease burden. Support from genetic counselors was regarded as facilitative for considering hereditary basis of CRC diagnosis, but there was variability in awareness of and access to this expertise. Our data suggest the need for tools and policies to establish and disseminate well-defined processes for accessing services and adhering to guidelines.

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Published In

J Pers Med

DOI

ISSN

2075-4426

Publication Date

April 28, 2016

Volume

6

Issue

2

Location

Switzerland

Related Subject Headings

  • 3214 Pharmacology and pharmaceutical sciences
  • 3206 Medical biotechnology
  • 3205 Medical biochemistry and metabolomics
 

Citation

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Sperber, N. R., Andrews, S. M., Voils, C. I., Green, G. L., Provenzale, D., & Knight, S. (2016). Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration. J Pers Med, 6(2). https://doi.org/10.3390/jpm6020016
Sperber, Nina R., Sara M. Andrews, Corrine I. Voils, Gregory L. Green, Dawn Provenzale, and Sara Knight. “Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.J Pers Med 6, no. 2 (April 28, 2016). https://doi.org/10.3390/jpm6020016.
Sperber NR, Andrews SM, Voils CI, Green GL, Provenzale D, Knight S. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration. J Pers Med. 2016 Apr 28;6(2).
Sperber, Nina R., et al. “Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration.J Pers Med, vol. 6, no. 2, Apr. 2016. Pubmed, doi:10.3390/jpm6020016.
Sperber NR, Andrews SM, Voils CI, Green GL, Provenzale D, Knight S. Barriers and Facilitators to Adoption of Genomic Services for Colorectal Care within the Veterans Health Administration. J Pers Med. 2016 Apr 28;6(2).

Published In

J Pers Med

DOI

ISSN

2075-4426

Publication Date

April 28, 2016

Volume

6

Issue

2

Location

Switzerland

Related Subject Headings

  • 3214 Pharmacology and pharmaceutical sciences
  • 3206 Medical biotechnology
  • 3205 Medical biochemistry and metabolomics