Atkins, L;
Hunkeler, EM;
Jensen, CD;
Michie, S;
Lee, JK;
Doubeni, CA;
Zauber, AG;
... Corley, DA; + view all
(2016)
Factors influencing variation in physician adenoma detection rates: a theory-based approach for performance improvement.
Gastrointestinal Endoscopy
, 83
(3)
617-626.e2.
10.1016/j.gie.2015.08.075.
Preview |
Text
Atkins Factors influencing variation in physician adenoma detection rates.pdf Download (588kB) | Preview |
Abstract
BACKGROUND AND AIMS: Interventions to improve physician adenoma detection rates for colonoscopy have generally not been successful, and there are little data on the factors contributing to variation that may be appropriate targets for intervention. We sought to identify factors that may influence variation in detection rates by using theory-based tools for understanding behavior. METHODS: We separately studied gastroenterologists and endoscopy nurses at 3 Kaiser Permanente Northern California medical centers to identify potentially modifiable factors relevant to physician adenoma detection rate variability by using structured group interviews (focus groups) and theory-based tools for understanding behavior and eliciting behavior change: the Capability, Opportunity, and Motivation behavior model; the Theoretical Domains Framework; and the Behavior Change Wheel. RESULTS: Nine factors potentially associated with adenoma detection rate variability were identified, including 6 related to capability (uncertainty about which types of polyps to remove, style of endoscopy team leadership, compromised ability to focus during an examination due to distractions, examination technique during withdrawal, difficulty detecting certain types of adenomas, and examiner fatigue and pain), 2 related to opportunity (perceived pressure due to the number of examinations expected per shift and social pressure to finish examinations before scheduled breaks or the end of a shift), and 1 related to motivation (valuing a meticulous examination as the top priority). Examples of potential intervention strategies are provided. CONCLUSIONS: By using theory-based tools, this study identified several novel and potentially modifiable factors relating to capability, opportunity, and motivation that may contribute to adenoma detection rate variability and be appropriate targets for future intervention trials.
| Type: | Article |
|---|---|
| Title: | Factors influencing variation in physician adenoma detection rates: a theory-based approach for performance improvement |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.gie.2015.08.075 |
| Publisher version: | http://dx.doi.org/10.1016/j.gie.2015.08.075 |
| Language: | English |
| Additional information: | Copyright © 2016 by the American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1483193 |
Archive Staff Only
 |
View Item |
