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. 2023 Mar;20(3):342-351.
doi: 10.1016/j.jacr.2022.12.019.

Barriers to Implementation of Breast Cancer Risk Assessment: The Health Care Team Perspective

Lucy B Spalluto  1 , Kemberlee Bonnet  2 , Chiamaka Sonubi  3 , Laura L Ernst  4 , Rifat Wahab  5 , Sonya A Reid  6 , Pooja Agrawal  7 , Kris Gregory  8 , Katie M Davis  9 , Jennifer A Lewis  10 , Elizabeth Berardi  11 , Crissy Hartsfield  12 , Rebecca Selove  13 , Maureen Sanderson  14 , David Schlundt  2 , Carolyn M Audet  15
Affiliations

Barriers to Implementation of Breast Cancer Risk Assessment: The Health Care Team Perspective

Lucy B Spalluto et al. J Am Coll Radiol. 2023 Mar.

Abstract

Purpose: To assess health care professionals' perceptions of barriers to the utilization of breast cancer risk assessment tools in the public health setting through a series of one-on-one interviews with health care team members.

Methods: We conducted a cross-sectional qualitative study consisting of one-on-one semistructured telephone interviews with health care team members in the public health setting in the state of Tennessee between May 2020 and October 2020. An iterative inductive-deductive approach was used for qualitative analysis of interview data, resulting in the development of a conceptual framework to depict influences of provider behavior in the utilization of breast cancer risk assessment.

Results: A total of 24 interviews were completed, and a framework of influences of provider behavior in the utilization of breast cancer risk assessment was developed. Participants identified barriers to the utilization of breast cancer risk assessment (knowledge and understanding of risk assessment tools, workflow challenges, and availability of personnel); patient-level barriers as perceived by health care team members (psychological, economic, educational, and environmental); and strategies to increase the utilization of breast cancer risk assessment at the provider level (leadership buy-in, training, supportive policies, and incentives) and patient level (improved communication and better understanding of patients' perceived cancer risk and severity of cancer).

Conclusions: Understanding barriers to implementation of breast cancer risk assessment and strategies to overcome these barriers as perceived by health care team members offers an opportunity to improve implementation of risk assessment and to identify a racially, geographically, and socioeconomically diverse population of young women at high risk for breast cancer.

Keywords: Breast cancer; implementation science; mammography; risk assessment.

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Conflict of interest statement

Disclosures/Conflicts of Interest:

The authors report no relevant conflicts of interest.

Figures

Figure 1.
Figure 1.
Provider Perceptions of the Influences of Behavior in Utilization of Breast Cancer Risk Assessment (RA). This framework describes provider perceived barriers and facilitators of utilization of breast cancer RA at both the provider-level and patient-level and depicts challenges with resultant RA results.
See this image and copyright information in PMC

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