{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T15:19:10Z","timestamp":1747149550086,"version":"3.40.5"},"reference-count":36,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T00:00:00Z","timestamp":1579651200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K12HS022982"],"award-info":[{"award-number":["K12HS022982"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Genetic Counseling"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Despite clinical guidelines, programs conducting population\u2010based screening and genetic service delivery for hereditary cancer prevention and control are rare in practice. We interviewed individuals (<jats:italic>n<\/jats:italic>\u00a0=\u00a013) instrumental in implementing seven unique clinical programs conducting either universal tumor screening for Lynch Syndrome or routine family history screening and provision of genetic services for hereditary breast and ovarian cancer in the United States. To characterize determinants of readiness to implement population\u2010based cancer genetic service delivery models, interviews and deductive codes drew on Weiner's theory of organizational readiness for change. Qualitative analysis identified themes across programs. The degree to which organizational stakeholders valued moving to a population\u2010based genetic service delivery model depended on the existence of aligned clinical guidelines at the time of program implementation. However, judgments of implementation capacity within the organization, particularly with respect to task demands and resource concerns, were more often barriers to readiness. Program champions were essential to facilitating readiness, frequently taking on substantial uncompensated work. These data suggest that developing interventions targeting change efficacy and cultivating practice change champions may be two promising ways to increase uptake of population\u2010based hereditary cancer screening and genetic service delivery in clinical practice.<\/jats:p>","DOI":"10.1002\/jgc4.1216","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T10:40:33Z","timestamp":1579689633000},"page":"867-876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Organizational readiness to implement population\u2010based screening and genetic service delivery for hereditary cancer prevention and control"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5461-6298","authenticated-orcid":false,"given":"Sarah","family":"Knerr","sequence":"first","affiliation":[{"name":"Department of Health Services University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0770-5316","authenticated-orcid":false,"given":"Kathleen M.","family":"West","sequence":"additional","affiliation":[{"name":"Department of Bioethics and Humanities University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7387-7581","authenticated-orcid":false,"given":"Frank A.","family":"Angelo","sequence":"additional","affiliation":[{"name":"Department of Health Services University of Washington Seattle WA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,1,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1353\/hpu.2012.0178"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.4719"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.0b013e31823375ea"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10897-012-9547-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000341889"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2014.31"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ejhg.2014.180"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e31818fa2ff"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.04.001"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2013.101"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2014.147"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.74.7899"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.66.0019"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312118773261"},{"volume-title":"Qualitative data analysis: A sourcebook of new methods","year":"1994","author":"Miles M.","key":"e_1_2_9_16_1"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2747"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2018.08.038"},{"volume-title":"NCCN guidelines Version 2. 2017 Genetics\/familial high\u2010risk assessment: Breast and ovarian","year":"2017","author":"National Comprehensive Cancer Network (NCCN)","key":"e_1_2_9_19_1"},{"volume-title":"NCCN guidelines Version 1. 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