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FQHC Qualitative Inquiry Subgroup Maria E. Fernandez, PhD

Focus Group conducted at the National Association of Community Health Center (NACHC) Conference Preliminary Findings Oct 5th, 2011. FQHC Qualitative Inquiry Subgroup Maria E. Fernandez, PhD Associate Professor of Health Promotion and Behavioral Sciences

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FQHC Qualitative Inquiry Subgroup Maria E. Fernandez, PhD

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  1. Focus Group conducted at the National Association of Community Health Center (NACHC) ConferencePreliminary FindingsOct 5th, 2011 FQHC Qualitative Inquiry Subgroup Maria E. Fernandez, PhD Associate Professor of Health Promotion and Behavioral Sciences University Of Texas Health Science Center at Houston School of Public Health

  2. Outline 1. Development of Focus Group Guide 2. Focus group guide overview 3. Participants 4. Major practice changes 5. Preliminary analysis based on CFIR 6. Summary 7. Next steps

  3. Focus Group Guide Development • Qualitative Inquiry Subgroup (QIS) members met several times and drafted the guide • Appreciative Inquiry questions—Dr. Betsy Risendal • CFIR Questions—Dr. Michelle Kegler • Implementation process and characteristics questions—Dr. Maria Fernandez and Glenna Dawson • FQHC Workgroup provided feedback • External feedback from Dr. Kurt Stange and Dr. Bryan Weiner

  4. Focus Group Guide Overview • Part I: Example of successful practice changes • Part II: Explore evidence-based cancer prevention and control strategy (Example: Tobacco Cessation: Ask-Advise-Refer) • Part III: Inner setting—organizational characteristics and readiness for implementation • Part IV: Other domains of CFIR—intervention characteristics and outer settings

  5. Participants • Facilitator: Glenna Dawson • Observers: Dr. Michelle Kegler, Dr. Vicki Young, and Michelle Proser • Focus group participants • 2 male and 2 female • All are Medical Directors/ Chief Medical Officers • From South Carolina, Georgia and Texas • CHCs range in size from 5 to 12 sites

  6. Major Practice Change • Electronic Medical Records (EMR) • Patient-Centered Medical Home (PCMH) • Cancer control practice • CRC screening initiative with navigator program • PSA tests and media campaign • Breast and cervical cancer screening and follow up • Ask-Advise-Refer • Other: Vitamin D deficiency test

  7. Preliminary Analysis Based on Consolidated Framework for Implementation Research (CFIR) • Domain 1: Implementation Characteristics • Domain 2: Inner Setting • Domain 3: Outer Setting • Domain 4: Characteristics of Individuals Domain 5: Process of Implementation

  8. Domain1: Intervention Characteristics

  9. Domain 2: Inner Setting

  10. Domain 2: Inner Setting (Cont.)

  11. Domain 2: Inner Setting (Cont.)

  12. Domain 3: Outer Setting

  13. Domain 4: Characteristics of Individuals

  14. Domain 5: Process of Implementation

  15. Summary • Findings fit well within CFIR constructs • Connections and partnerships with academics are very important for CHCs’ practice change • Federal regulation and national visionary goals drive changes • CHCs are willing to change given the right tool to implement changes

  16. Next Steps • Appreciative Inquiry during an “Intensive workshop” at the 21st Annual Midwest Stream Farmworker Health Forum • Nov 10th –12th, 2011; Albuquerque, NM • Three hours (180 min) available • Attendants include: Medical directors, mid-level managers, frontline workers (health educators, lay health workers, etc.)

  17. Discussion • How shall we approach this “intensive workshop”? • Pure Appreciative Inquiry? • Focus on certain constructs? • What shall we provide for the attendants?

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