Evidence map›Paper›PMID 39227912›Full record

ArticleImplementation science communications2024

Applying cognitive walkthrough methodology to improve the usability of an equity-focused implementation strategy.

Kelly A Aschbrenner, Emily R Haines, Gina R Kruse, Ayotola O Olugbenga, Annette N Thomas, Tanveer Khan, Stephanie Martinez, Karen M Emmons, Stephen J Bartels

Abstract read
In one paragraph

Article in Implementation science communications, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kelly A AschbrennerDepartment of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA. kelly.aschbrenner@dartmouth.edu.ORCID http://orcid.org/0000-0001-6243-2421
Emily R HainesWake Forest University School of Medicine, 525 Vine Street, Winston-Salem, NC, 27101, USA.
Gina R KruseDivision of General Internal Medicine, University of Colorado School of Medicine, 13001 E 17th PL, Aurora, CO, 80045, USA.
Ayotola O OlugbengaBrockton Neighborhood Health Center, 63 Main Street, Brockton, MA, 02301, USA.
Annette N ThomasBrockton Neighborhood Health Center, 63 Main Street, Brockton, MA, 02301, USA.
Tanveer KhanHarvard Street Neighborhood Health Center, 632 Blue Hill Ave, Dorchester, MA, 02121, USA.
Stephanie MartinezMassachusetts General Hospital, 125 Nashua St, Boston, MA, 02114, USA.
Karen M EmmonsHarvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
Stephen J BartelsMassachusetts General Hospital, 125 Nashua St, Boston, MA, 02114, USA.

Funding

The Implementation Science Center for Cancer Control Equity - Research ProgramP50CA244433 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI EMMONS, KAREN M. · 2019 to 2023
$12.5M
NCI NIH HHS P50 CA244433
6 · The paper itself

Abstract

backgroundOur research team partnered with primary care and quality improvement staff in Federally Qualified Community Health Centers (CHCs) to develop Partnered and Equity Data-Driven Implementation (PEDDI) to promote equitable implementation of evidence-based interventions. The current study used a human-centered design methodology to evaluate the usability of PEDDI and generate redesign solutions to address usability issues in the context of a cancer screening intervention.

methodsWe applied the Cognitive Walkthrough for Implementation Strategies (CWIS), a pragmatic assessment method with steps that include group testing with end users to identify and prioritize usability problems. We conducted three facilitated 60-min CWIS sessions with end users (N = 7) from four CHCs that included scenarios and related tasks for implementing a colorectal cancer (CRC) screening intervention. Participants rated the likelihood of completing each task and identified usability issues and generated ideas for redesign solutions during audio-recorded CWIS sessions. Participants completed a pre-post survey of PEDDI usability. Our research team used consensus coding to synthesize usability problems and redesign solutions from transcribed CWIS sessions.

resultsUsability ratings (scale 0-100: higher scores indicating higher usability) of PEDDI averaged 66.3 (SD = 12.4) prior to the CWIS sessions. Scores averaged 77.8 (SD = 9.1) following the three CWIS sessions improving usability ratings from "marginal acceptability" to "acceptable". Ten usability problems were identified across four PEDDI tasks, comprised of 2-3 types of usability problems per task. CWIS participants suggested redesign solutions that included making data fields for social determinants of health and key background variables for identifying health equity targets mandatory in the electronic health record and using asynchronous communication tools to elicit ideas from staff for adaptations.

conclusionsUsability ratings indicated PEDDI was in the acceptable range following CWIS sessions. Staff identified usability problems and redesign solutions that provide direction for future improvements in PEDDI. In addition, this study highlights opportunities to use the CWIS methodology to address inequities in the implementation of cancer screening and other clinical innovations in resource-constrained healthcare settings.

Indexed as

Cancer preventionCancer screeningCognitive walkthroughHealth equityHuman-centered designImplementation strategiesUsability

Identifiers

PMID39227912
PMCPMC11373107

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.