Primary care professionals (PCPs) are responsible for identifying patients who are eligible for all recommended screenings. Eligibility is difficult, given the number of screenings recommended by the French National Authority for Health (HAS), and the complexity of defining risk groups. When eligibility for one or more screenings is identified, the PCP informs the patient and can help him or her make the decision, considering his or her values and preferences. Lack of information for patients and lack of time for PCPs are the main obstacles to prevention in primary care (PC). Another barrier identified is the lack of opportunity for patients who do not consult their PCP very often, as they are less likely to be approached for preventive interventions due to other more urgent reasons for consultation. A Medical Decision Support System (MDSS) is a software application designed to be a direct aid to clinical decision-making, in which an inference engine matches individual patient characteristics with a computerized knowledge base or machine-learning algorithm to propose a risk assessment or adapted recommendations to the healthcare professional and/or patient. The aim of the ADER-F research program is to support the development and evaluation of a complex intervention centred on the use of a MDSS called "Lianeli". This complex intervention will ultimately contribute to structuring new consultations dedicated to prevention in general practice, by improving the physician's sense of self-efficacy in conducting the shared screening decision, and reducing the patient's decision-making conflict.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
210
The Lianeli SADM is designed to facilitate the identification of patients eligible for screenings recommended by the HAS (French National Authority for Health) and to facilitate shared decision-making during a primary care consultation dedicated to prevention. The Lianeli SADM will be used by the patient first via a health questionnaire, then by the patient and the general practitioner during the consultation dedicated to prevention.
24 Semi-structured individual interviews will be conducted with a sample of volunteer patients, one month after the end of their follow-up, by a psychologist specializing in qualitative studies. The objective is to describe qualitatively the feasibility criteria for implementing the intervention according to the GUIDES checklist domains (A favorable context of use, appropriate content, a high-performance system, adequate implementation)
Semi-structured individual interviews or focus groups with 24 primary care professionals will be conducted by a psychologist specializing in qualitative studies with a sample of volunteers, one month after the last patient's last visit to the center. The objective is to describe qualitatively the feasibility criteria for implementing the intervention according to the GUIDES checklist domains (A favorable context of use, appropriate content, a high-performance system, adequate implementation)
Cabinet médical
Belley, France
RECRUITINGCabinet médical
Beynost, France
RECRUITINGCSCP - Centre de Santé Communautaire et Planétaire
Bron, France
NOT_YET_RECRUITINGCSCP - Centre de Santé Communautaire et Planétaire
Bron, France
NOT_YET_RECRUITINGCSCP - Centre de Santé Communautaire et Planétaire
Bron, France
NOT_YET_RECRUITINGCSCP - Centre de Santé Communautaire et Planétaire
Bron, France
NOT_YET_RECRUITINGCabinet médical
Craponne, France
NOT_YET_RECRUITINGMSP
Crêches-sur-Saône, France
RECRUITINGMaison de santé Gleizé Epinay
Gleizé, France
RECRUITINGGroupe Médical Claude Bernard
LArbresle, France
RECRUITING...and 10 more locations
Lianeli SADM fully used
The primary outcome is a composite criterion. This composite criterion is the proportion of patients with full use of the Lianeli SADM. A "yes" answer to the three following items defines full use of the Lianeli SADM: * Validation by the patient of their answers to the Lianeli health questionnaire (yes/no) * Validation by the general practitioner of the patient's responses to the Lianeli health questionnaire (yes/no) * Completion of the consultation dedicated to screening (yes/no)
Time frame: Within 60 days of the inclusion consultation
Lianeli SADM fully used
Proportion of patients included for whom the Lianeli SADM was fully used : Verification of the questionnaire by the GP (validate/not validated)
Time frame: Within 60 days of the inclusion consultation
Lianeli SADM fully used
Proportion of patients included for whom the Lianeli SADM was fully used : Dedicated screening consultation with the GP (done/not done)
Time frame: Within 60 days of the inclusion consultation
Feasibility criteria - GUIDES
Describe quantitatively the feasibility criteria for the implementation of the ADER-F intervention according to the GUIDES checklist domains. The checklist GUIDES is the standard for evaluating indicators that promote the implementation of an CDS (computerized decision support) system based on clinical practice recommendations. According to this guide, indicators evenly distributed across four areas (a favorable context for use, an appropriate content, an effective system, a proper implementation) determine the success of an CDS system implementation. Questionnaire GUIDES consists of 12 items distributed across this four areas. Each item is scored using a 7-point Likert scale. Responses were code as follows : 1 for strongly disagree, 2 for disagree, 3 for somewhat disagree, 4 for undecided, 5 for somewhat agree, 6 for agree, 7 for strongly agree. The scores per domain are the average of the scores assigned to the various items comprising each domain (range 1 to 7). Domains with l
Time frame: Within 60 days of the inclusion consultation
Feasibility crtiteria (Patient satisfaction questionnaire)
Describe quantitatively the feasibility criteria for the implementation of the ADER-F intervention according to the GUIDES checklist domains using patient satisfaction questionnaire (12 items - 7-point Likert scale). The satisfaction questionnaire is interpreted according to the areas of the GUIDES Check List. According to this guide, 16 indicators, evenly distributed across 4 areas, determine the success of implementing a SADM (Simplified Access Management System). These four areas lead researchers to ensure that the context of use is favorable, the content appropriate, the system efficient, and the implementation adequate.
Time frame: Within 30 days after the dedicated screening consultation with the GP
Feasibility criteria (Primary care professional satisfaction questionnaire)
Describe quantitatively the feasibility criteria for the implementation of the ADER-F intervention according to the areas GUIDES checklist domains using primary care professional questionnaire (11 items - 7-point Likert scale)
Time frame: Within 30 days after the dedicated screening consultation with the GP
Patient usability of Lianeli SADM
Assessment of the Lianeli SADM user experience (patient and Primary care professional) using the SUS scale The System Usability Scale (SUS) is a questionnaire for measuring the usability of interactive systems, comprising ten items formulated in the form of affirmative sentences. For each sentence, users are asked to express their agreement or disagreement, using a 5-point Lickert scale. Assessment of the Lianeli SADM user experience (patient and Primary care professional) using the SUS scale The System Usability Scale (SUS) is a questionnaire for measuring the usability of interactive systems, comprising ten items formulated in the form of affirmative sentences. For each sentence, users are asked to express their agreement or disagreement, using a 5-point Lickert scale. The results of the SUS questionnaire are used to calculate the satisfaction score. This score ranges from 1 to 100. A score of 75 or above is generally considered "good," while a score between 50 and 75 is considered
Time frame: Within 30 days after the dedicated screening consultation with the GP
Interprofessional use of the Lianeli SADM
To assess the effect of interprofessional use of the Lianeli SADM on the primary endpoint. Interprofessional work will be defined as the collaboration of at least two healthcare professionals (including the general practitioner) with the patient as part of the ADER-F intervention
Time frame: Within 60 days of the inclusion consultation
HLS-UE16
To assess the effect of patients' health literacy on the primary endpoint. Health literacy will be assessed using the HLS-EU16 (European Health Literacy Survey Questionnaire). This questionnaire comprises 16 questions using a 5-point Likert scale. The HLS-EU16 L scale assesses one dimension of health literacy in the general population. The French version of the HLS-EU-Q16 has acceptable psychometric properties. European Health Literacy Survey Questionnaire (Erreur dans proto - échelle Likert en 4 points) The results of the HLS-EU16 scale reveal the health literacy levels of the participants. Responses were coded as follows: 0 for "quite difficult" and "very difficult," and 1 for "quite easy" and "very easy." The total score, which ranges from 0 to 16, allows participants' health literacy to be classified into three levels: Inadequate (0-8), Problematic (9-12), Sufficient (13-16)
Time frame: Within 60 days of the inclusion consultation
EPICES 11
EPICES : Assessment of Precarity and Health Inequalities in Health Examination Centers To assess the effect of patients' precariousness and health inequalities on the primary outcome. Health insecurity will be assessed using the EPICES scale. This questionnaire is an individual indicator of precariousness that considers the multidimensional nature of precariousness. It consists of 11 binary yes/no questions. The answer to each question is assigned a coefficient, and the sum of the 11 answers gives the EPICES score. The score is continuous, ranging from 0 (absence of precariousness) to 100 (maximum precariousness). A single score of 30.17 is considered relevant.
Time frame: Within 60 days of the inclusion consultation
Organized cancer screenings (breast, cervical and colorectal)
The proportion of patients for whom the intervention is likely to improve participation in the three organized cancer screenings (colorectal, breast, cervical) will be assessed within the population of patients identified as eligible for at least one of the three organized screenings (previous examination performed within a timeframe greater than the recommended timeframe, or never performed) by the proportion of patients who attended the dedicated screening consultation within 60 days of the inclusion consultation.
Time frame: Within 60 days of the inclusion consultation
Individual cancer screening
The proportion of patients for whom the intervention is likely to improve participation in opportunistic cancer screening will be assessed within the population of patients identified as eligible for at least one of the opportunistic cancer screenings (high-risk colorectal cancer, high-risk breast cancer, high-risk stomach cancer - previous examination performed within a timeframe greater than the recommended timeframe or never performed) by the proportion of patients who attended the dedicated screening consultation within 60 days of the inclusion consultation.
Time frame: Within 60 days
Feasibility criteria - metadata
Describe quantitatively the feasibility criteria for the implementation of the ADER-F intervention from Lianeli usage metadata
Time frame: Within 60 days of the inclusion consultation
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