Article Document Academic Article Information Content Entity Journal Article Continuant Continuant Entity Entity Generically Dependent Continuant 2025-05-07T20:56:23 RDF description of Identifying factors and causal chains associated with optimal implementation of Lynch syndrome tumor screening: an application of coincidence analysis - http://repository.healthpartners.com/individual/document-rn37056 26 Screening public Identifying factors and causal chains associated with optimal implementation of Lynch syndrome tumor screening: an application of coincidence analysis <p>PURPOSE: This study compared Lynch syndrome universal tumor screening (UTS) across multiple health systems (some of which had 2 or more distinct UTS programs) to understand multilevel factors that may affect the successful implementation of complex programs. METHODS: Data from 66 stakeholder interviews were used to conduct multivalue coincidence analysis and identify key factors that consistently make a difference in whether UTS programs were implemented and optimized at the system level. RESULTS: The selected coincidence analysis model revealed combinations of conditions that distinguish 4 optimized UTS programs, 10 nonoptimized programs, and 4 systems with no program. Fully optimized UTS programs had both a maintenance champion and a positive inner setting. Two independent paths were unique to nonoptimized programs: (1) positive attitudes and a mixed inner setting or (2) limited planning and engaging among stakeholders. Negative views about UTS evidence or lack of knowledge about UTS led to a lack of planning and engaging, which subsequently prevented program implementation. CONCLUSION: The model improved our understanding of program implementation in health care systems and informed the creation of a toolkit to guide UTS implementation, optimization, and changes. Our findings and toolkit may serve as a use case to increase the successful implementation of other complex precision health programs.<p> 10.1016/j.gim.2024.101201 document-rn37056 Colorectal Cancer 22911 39522 Genetics Genetics in Medicine 10 2024-08-31T22:03:57.593-05:00