Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study
Despite the overwhelming interest in clinical genomics, uptake has been slow. Implementation science offers a systematic approach to reveal pathways to adoption and a theory informed approach to addressing barriers presented. Using case study methodology, we undertook 16 in-depth interviews with non...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2021-02-01
|
Series: | Genes |
Subjects: | |
Online Access: | https://www.mdpi.com/2073-4425/12/2/317 |
id |
doaj-c00ceca0893643c79ca5553ced891f8f |
---|---|
record_format |
Article |
spelling |
doaj-c00ceca0893643c79ca5553ced891f8f2021-02-24T00:06:11ZengMDPI AGGenes2073-44252021-02-011231731710.3390/genes12020317Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case StudyStephanie Best0Janet C. Long1Clara Gaff2Jeffrey Braithwaite3Natalie Taylor4Australian Institute of Health Innovation, Macquarie University, Sydney, NSW 2113, AustraliaAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW 2113, AustraliaMelbourne Genomics Health Alliance, Walter and Eliza Hall Institute, Melbourne, VIC 3052, AustraliaAustralian Institute of Health Innovation, Macquarie University, Sydney, NSW 2113, AustraliaCancer Research Division, Cancer Council New South Wales, Sydney, NSW 2011, AustraliaDespite the overwhelming interest in clinical genomics, uptake has been slow. Implementation science offers a systematic approach to reveal pathways to adoption and a theory informed approach to addressing barriers presented. Using case study methodology, we undertook 16 in-depth interviews with nongenetic medical specialists to identify barriers and enablers to the uptake of clinical genomics. Data collection and analysis was guided by two evidence-based behaviour change models: the Theoretical Domains Framework (TDF), and the Capability, Opportunity Motivation Behaviour model (COM-B). Our findings revealed the use of implementation science not only provided a theoretical structure to frame the study but also facilitated uncovering of traditionally difficult to access responses from participants, e.g., “safety in feeling vulnerable” (TDF code emotion/COM-B code motivation). The most challenging phase for participants was ensuring appropriate patients were offered genomic testing. There were several consistent TDF codes: professional identity, social influences, and environmental context and resources and COM-B codes opportunity and motivation, with others varying along the patient journey. We conclude that implementation science methods can maximise the value created by the exploration of factors affecting the uptake of clinical genomics to ensure future interventions are designed to meet the needs of novice nongenetic medical specialists.https://www.mdpi.com/2073-4425/12/2/317clinical genomicsimplementation scienceTheoretical Domains FrameworkCOM.B |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Stephanie Best Janet C. Long Clara Gaff Jeffrey Braithwaite Natalie Taylor |
spellingShingle |
Stephanie Best Janet C. Long Clara Gaff Jeffrey Braithwaite Natalie Taylor Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study Genes clinical genomics implementation science Theoretical Domains Framework COM.B |
author_facet |
Stephanie Best Janet C. Long Clara Gaff Jeffrey Braithwaite Natalie Taylor |
author_sort |
Stephanie Best |
title |
Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study |
title_short |
Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study |
title_full |
Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study |
title_fullStr |
Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study |
title_full_unstemmed |
Investigating the Adoption of Clinical Genomics in Australia. An Implementation Science Case Study |
title_sort |
investigating the adoption of clinical genomics in australia. an implementation science case study |
publisher |
MDPI AG |
series |
Genes |
issn |
2073-4425 |
publishDate |
2021-02-01 |
description |
Despite the overwhelming interest in clinical genomics, uptake has been slow. Implementation science offers a systematic approach to reveal pathways to adoption and a theory informed approach to addressing barriers presented. Using case study methodology, we undertook 16 in-depth interviews with nongenetic medical specialists to identify barriers and enablers to the uptake of clinical genomics. Data collection and analysis was guided by two evidence-based behaviour change models: the Theoretical Domains Framework (TDF), and the Capability, Opportunity Motivation Behaviour model (COM-B). Our findings revealed the use of implementation science not only provided a theoretical structure to frame the study but also facilitated uncovering of traditionally difficult to access responses from participants, e.g., “safety in feeling vulnerable” (TDF code emotion/COM-B code motivation). The most challenging phase for participants was ensuring appropriate patients were offered genomic testing. There were several consistent TDF codes: professional identity, social influences, and environmental context and resources and COM-B codes opportunity and motivation, with others varying along the patient journey. We conclude that implementation science methods can maximise the value created by the exploration of factors affecting the uptake of clinical genomics to ensure future interventions are designed to meet the needs of novice nongenetic medical specialists. |
topic |
clinical genomics implementation science Theoretical Domains Framework COM.B |
url |
https://www.mdpi.com/2073-4425/12/2/317 |
work_keys_str_mv |
AT stephaniebest investigatingtheadoptionofclinicalgenomicsinaustraliaanimplementationsciencecasestudy AT janetclong investigatingtheadoptionofclinicalgenomicsinaustraliaanimplementationsciencecasestudy AT claragaff investigatingtheadoptionofclinicalgenomicsinaustraliaanimplementationsciencecasestudy AT jeffreybraithwaite investigatingtheadoptionofclinicalgenomicsinaustraliaanimplementationsciencecasestudy AT natalietaylor investigatingtheadoptionofclinicalgenomicsinaustraliaanimplementationsciencecasestudy |
_version_ |
1724253507208347648 |