Defining the Transition from New to Normal: A Qualitative Investigation of the Clinical Change Process
Clinical practice has been unable to keep up with the overwhelming volume and pace of changing care guidelines and evidence-based interventions. Identifying indicators of change to know when a practice change becomes standardized is important to foster successful and sustained implementation efforts. We are analyzing qualitative interviews with clinical leaders in implementation or quality improvement within health systems to explore strategies utilized to facilitate practice change and understand how participants define when a successful practice change has occurred.
A Mixed Methods Exploration of Diabetes Management Strategies, Barriers, and Facilitators Experienced by Black and Latino People with Diabetes in a Safety Net Hospital Setting
Diabetes is increasingly prevalent and disproportionately burdens minoritized communities. Among populations who experience high rates of adverse social determinants of health, data are limited regarding patient self-reported challenges to diabetes management and preferences for healthcare system-based interventions to address them. We are conducting a mixed-methods study to explore self-reported diabetes management strategies and barriers to care to identify intervention targets for future implementation science research and quality improvement programs.
Decades of Devotion: A Qualitative Exploration of Framingham Heart Study Participant Engagement
The Framingham Heart Study (FHS) has experienced declines in participant engagement. This study aims to qualitatively understand participant experiences with the FHS through exploring motivators and challenges to ongoing engagement, investigating preferences for being recruited for ancillary studies, and elicit recommendations to improve the experience or lessen the burden. Ultimately, we aim to identify actionable suggestions to mediate barriers to improve FHS retention.
Primary Care and Endocrine Clinician Knowledge and Perspectives on Screening for NAFLD
Recent clinical practice guidelines1,2 have expanded indications for non-alcoholic fatty liver disease (NAFLD) risk stratification and evaluation to include obesity, prediabetes, and type 2 diabetes. These are conditions common in safety-net primary care clinics and highly prevalent in endocrinology clinics. Safety-net clinician knowledge and perspectives on screening for NAFLD are unclear. We are conducting a sequential explanatory mixed-methods study to explore the implementation context in anticipation of an initiative to test an electronic health record (EHR) tool to increase NAFLD screening in primary care and endocrinology clinics.
Improving Evidence-based Care of Smokers Through Patient Engagement with the Electronic Health Record
We are collaborating with clinical partners on a mixed-methods study to improve accuracy of charted smoking history in the electronic health record and subsequent lung cancer screening, ASCVD scoring, and smoking cessation referrals through iterative testing effectiveness of a variety of message framings to initiate patient-reported surveys on social history.