• Sara E Golden, Jessica J Currier, NithyaPriya Ramalingam, Mary Patzel, Jackilen Shannon, Melinda M Davis, and Christopher G Slatore.
• From the Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Portland, OR (SFG, CGS), Division of Oncological Sciences, Oregon Health & Science University (OHSU); Portland, OR (JC, JS), Oregon Rural Practice-based Research Network, OHSU; Portland, OR, (NPR, MP, MMD), Department of Family Medicine, OHSU; Portland, OR (MMD), OHSU-PSU School of Public Health, OHSU; Portland, OR (MMD), Division of Pulmonary, Allergy, & Critical Care Medicine, OHSU; Portland, OR (CGS), Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System; Portland, OR (CGS). sara.golden1@va.gov.
• J Am Board Fam Med. 2024 Jan 5; 36 (6): 952965952-965.

PurposeDescribe primary care providers' (PCPs) barriers and facilitators to implementation of lung cancer screening programs in rural settings.MethodsWe conducted qualitative interviews with PCPs practicing in rural Oregon from November 2019 to September 2020. The interview questions and analytic framework were informed by the 2009 Consolidated Framework for Implementation Research. We used inductive and deductive approaches for analysis.ResultsWe interviewed 15 key participants from 12 distinct health care systems. We identified several Consolidated Framework for Implementation Research factors affecting lung cancer screening implementation. 1) Most PCPs did not have workflows to assist in discussing screening and relied on their memory and knowledge of the patient's history to prompt discussions. PCPs supported screening and managed the patient throughout the process. 2) PCPs reported several patient-level barriers, including geographic access to lung cancer screening scans and out-of-pocket cost concerns. 3) PCPs reported that champions are necessary to create opportunities for local practices to adopt lung cancer screening programs.ConclusionsRural-practicing PCPs were supportive of lung cancer screening, however workflow processes, time challenges, and patient-reported barriers remain impediments to improved screening in their clinics. We identified several areas for improvement in lung cancer screening implementation in rural primary care practices, ranging from designing clinic workflows and processes to designating clinic staff to support referral, screening, and follow-up care for patients.© Copyright by the American Board of Family Medicine.

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