Examining readiness for implementing practice changes in federally qualified health centers: A rapid qualitative study
Emanuelle Dias, Timothy J. Walker, Derek W. Craig, Robert W. Gibson, Jacob Szeszulski, Heather M. Brandt, Hiluv Johnson, Andrea Lamont, Abraham Wandersman, María E. Fernández
Abstract
Abstract Implementing evidence‐based interventions remains slow in federally qualified health centers (FQHCs). The purpose of this study is to qualitatively examine the R = MC 2 ( R eadiness = m otivation × innovation specific c apacity × general c apacity) heuristic subcomponents in the context of implementing general and colorectal cancer screening (CRCS)‐related practice changes in FQHCs. We conducted 17 interviews with FQHC employees to examine (1) experiences with successful or unsuccessful practice change efforts, (2) using approaches to promote CRCS, and (3) opinions about R = MC 2 subcomponents. We conducted a rapid qualitative analysis to examine the frequency, depth, and spontaneity of subcomponents. Priority, compatibility, observability (motivation), intra‐ and interorganizational relationships (innovation‐specific capacity), and organizational structure and resource utilization (general capacity) emerged as highly relevant. For example, organizational structure was described as related to an organization's open communication during meetings to help with scheduling procedures. The results contribute to understanding organizational readiness in the FQHC setting and can be helpful when identifying and prioritizing barriers and facilitators that affect implementation.