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Author Notes:

Lucy B. Spalluto, MD MPH, Department of Radiology, 1161 21st Avenue, South, Nashville, TN 37232, Telephone: (615) 322-1585, Fax: (615) 343-0746, Email: lucy.b.spalluto@vumc.org

All authors substantially contributed to the design of the work, the writing and revision of the manuscript, approved the final version of the manuscript and are accountable for the manuscript’s contents.

LBS, JAL, and CCL serve on the Steering Committee for this VAMC lung screening program. JAL and CCL are clinical co-directors of the clinical lung cancer screening program. Neither receive financial compensation for these roles. CGS is the co-director of his facility’s lung cancer screening program and does not receive financial compensation for that role.

FY is a named inventor on a number of patents and patent applications relating to the evaluation of diseases of the chest including measurement of nodules. Some of these, which are owned by Cornell Research Foundation (CRF), are non-exclusively licensed to General Electric. As an inventor of these patents, DFY is entitled to a share of any compensation which CRF may receive from its commercialization of these patents. He is also an equity owner in Accumetra, a privately held technology company committed to improving the science and practice of image-based decision making. DFY also serves on the advisory board of GRAIL.

CIH is the President and serves on the board of the Early Diagnosis and Treatment Research Foundation. She receives no compensation from the Foundation. The Foundation is established to provide grants for projects, conferences, and public databases for research on early diagnosis and treatment of diseases. CIH is also a named inventor on a number of patents and patent applications relating to the evaluation of pulmonary nodules on CT scans of the chest which are owned by Cornell Research Foundation (CRF). Since 2009, CIH does not accept any financial benefit from these patents including royalties and any other proceeds related to the patents or patent applications owned by CRF.

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Research Funding:

This study was supported in part by the VA Office of Rural Health (LBS, JAL, CLR), Office of Academic Affiliations, Department of Veterans Affairs, VA National Quality Scholars Program (JAL, CLR,) with resources and use of facilities at VA Tennessee Valley Healthcare System, Nashville TN (LBS, JAL, VMY, CCL, CLR, PPM), the VA Boston Healthcare System (RSW), the VA Portland Health Care System (CGS), and the Phoenix Veterans Healthcare System (CIH).

The study was also supported in part by the Vanderbilt-Ingram Cancer Center Support Grant CA68485 (LBS, JAL, PPM), Vanderbilt Scholars in T4 Translational Research (VSTTaR) K12 Program, funded by the National Heart, Lung, and Blood Institute K12HL137943 (JAL and CLR) and Agency for Healthcare Research and Quality K01 HS25486-01 (DS) and Agency for Healthcare Research and Quality/Patient Centered Outcomes Research Institute K12 HS026395 (TV and CLR).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Radiology, Nuclear Medicine & Medical Imaging
  • Implementation science
  • lung cancer
  • lung cancer screening
  • organizational readiness
  • veteran
  • DOSE COMPUTED-TOMOGRAPHY
  • HEALTH-SERVICES RESEARCH
  • IMPLEMENTATION

Organizational Readiness for Lung Cancer Screening: A Cross-Sectional Evaluation at a Veterans Affairs Medical Center

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Journal Title:

JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY

Volume:

Volume 18, Number 6

Publisher:

, Pages 809-819

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Objectives: Lung cancer has the highest cancer-related mortality in the United States and among Veterans. Screening of high-risk individuals with low-dose CT (LDCT) can improve survival through detection of early-stage lung cancer. Organizational factors that aid or impede implementation of this evidence-based practice in diverse populations are not well described. We evaluated organizational readiness for change and change valence (belief that change is beneficial and valuable) for implementation of LDCT screening. Methods: We performed a cross-sectional survey of providers, staff, and administrators in radiology and primary care at a single Veterans Affairs Medical Center. Survey measures included Shea's validated Organizational Readiness for Implementing Change (ORIC) scale and Shea's 10 items to assess change valence. ORIC and change valence were scored on a scale from 1 to 7 (higher scores representing higher readiness for change or valence). Multivariable linear regressions were conducted to determine predictors of ORIC and change valence. Results: Of 523 employees contacted, 282 completed survey items (53.9% overall response rate). Higher ORIC scores were associated with radiology versus primary care (mean 5.48, SD 1.42 versus 5.07, SD 1.22, β = 0.37, P = .039). Self-identified leaders in lung cancer screening had both higher ORIC (5.56, SD 1.39 versus 5.11, SD 1.26, β = 0.43, P = .050) and change valence scores (5.89, SD 1.21 versus 5.36, SD 1.19, β = 0.51, P = .012). Discussion: Radiology health professionals have higher levels of readiness for change for implementation of LDCT screening than those in primary care. Understanding health professionals’ behavioral determinants for change can inform future lung cancer screening implementation strategies.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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