title: Cancer screening at a federally qualified health center: a qualitative study on organizational challenges in the era of the patient-centered medical home.
abstract: Federally Qualified Health Centers (FQHCs) serve uninsured and minority populations, who have low cancer screening rates. The patient-centered medical home (PCMH) model aims to provide comprehensive preventive services, including cancer screening, to these populations. Little is known about organizational factors influencing the delivery of cancer screening in this context. We conducted 18 semi-structured interviews with clinic personnel at four FQHC clinics in Washington State. All interviews were recorded and transcribed verbatim and analyzed by two bilingual coders to identify salient themes. We found that screening on-site, scheduling separate visits for preventive care, and having non-provider staff recommend and schedule screening services facilitated the delivery of cancer screening. We found work overload to be a barrier to screening. To successfully implement screening strategies within the PCMH model, FQHCs must enhance facilitators and address organizational gaps in their cancer screening processes.
authors.affiliation: Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA. jmarting@med.puc.cl
authors.forename: Javiera
authors.initials: J
authors.lastname: Martinez-Gutierrez
authors.forename: Esther
authors.initials: E
authors.lastname: Jhingan
authors.forename: Antoinette
authors.initials: A
authors.lastname: Angulo
authors.forename: Ricardo
authors.initials: R
authors.lastname: Jimenez
authors.forename: Beti
authors.initials: B
authors.lastname: Thompson
authors.forename: Gloria D
authors.initials: GD
authors.lastname: Coronado
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D055088:Early Detection of Cancer; D057286:Electronic Health Records; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D009936:Organizational Innovation; D018802:Patient-Centered Care; D011320:Primary Health Care; D036301:Qualitative Research; D014861:Washington