{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T07:24:45Z","timestamp":1774596285657,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32TR004770"],"award-info":[{"award-number":["T32TR004770"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UM1TR004771"],"award-info":[{"award-number":["UM1TR004771"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24HL133373"],"award-info":[{"award-number":["K24HL133373"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Despite the growing interest in implementing genomic medicine into primary care, numerous barriers persist. Herein we present formative work conducted at three primary care clinics to identify barriers to implementation as part of a state\u2010funded genomic medicine initiative.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A convergent mixed\u2010methods case study was conducted across three family practice clinics participating in the Alabama Genomic Health Initiative. Quantitative, cross\u2010sectional surveys evaluated clinic personnel attitudes, implementation climate, and feasibility. Additionally, qualitative, semi\u2010structured interviews examined clinic personnel's perceptions of genomic medicine implementation into routine care, identified barriers to this integration, and investigated strategies for overcoming these barriers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Respondents exhibited positive attitudes towards genomic medicine while voicing concerns regarding time constraints, technological integration, lack of actionable results for certain patients, and inadequate implementation knowledge. Although the primary care climate was generally supportive of change, it was less conducive to the specific implementation of genomic medicine. External facilitators and educational resources were identified as critical for successful implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite primary care personnel acknowledging the preventive and diagnostic value of genomic medicine, the effective integration of this practice requires practical solutions to barriers such as resource limitations and specialized training needs, indicating that enhanced infrastructure and focused educational initiatives could facilitate its implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70397","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:03:46Z","timestamp":1772964226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Implementing Genomic Medicine in Primary Care: A Convergent Mixed Method Case Study"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5942-9516","authenticated-orcid":false,"given":"Emory W.","family":"Heffernan","sequence":"first","affiliation":[{"name":"Department of Neurology University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine R.","family":"Hearld","sequence":"additional","affiliation":[{"name":"Department of Health Services Administration University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene P.","family":"Moss","sequence":"additional","affiliation":[{"name":"Cystic Fibrosis Research Center University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly M.","family":"East","sequence":"additional","affiliation":[{"name":"HudsonAlpha Institute for Biotechnology Huntsville Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irfan M.","family":"Asif","sequence":"additional","affiliation":[{"name":"Department of Family &amp; Community Medicine University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Whitley V.","family":"Kelley","sequence":"additional","affiliation":[{"name":"HudsonAlpha Institute for Biotechnology Huntsville Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin W.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Department of Family &amp; Community Medicine University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Greg M.","family":"Cooper","sequence":"additional","affiliation":[{"name":"HudsonAlpha Institute for Biotechnology Huntsville Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce R.","family":"Korf","sequence":"additional","affiliation":[{"name":"Department of Genetics University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nita A.","family":"Limdi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heersink School of Medicine University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry R.","family":"Hearld","sequence":"additional","affiliation":[{"name":"Department of Health Services Administration University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes11070747"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13073-021-00886-y"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/jmg-2023-109470"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajhg.2018.11.014"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fgene.2022.867334"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/genes14112013"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13073-021-00855-5"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431-024-01547-5"},{"key":"e_1_2_13_10_1","unstructured":"Alabama Genomic Health Initiative. UAB Medicine. Published May 15 2024 accessed June 18 2025 https:\/\/www.uabmedicine.org\/specialties\/aghi\/."},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/gim.2016.190"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gim.2022.04.006"},{"key":"e_1_2_13_13_1","unstructured":"Center for Drug Evaluation and Research. Table of pharmacogenomic biomarkers. U.S. Food and Drug Administration accessed June 11 2025 https:\/\/www.fda.gov\/drugs\/science-and-research-drugs\/table-pharmacogenomic-biomarkers-drug-labeling."},{"key":"e_1_2_13_14_1","unstructured":"Clinical Pharmacogenetics Implementation Consortium (CPIC). Genes\u2013Drugs accessed June 18 2025 https:\/\/cpicpgx.org\/genes-drugs\/."},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-018-0736-7"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-7"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1073191114561254"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0635-3"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.8827"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-022-09001-2"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70397","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jep.70397","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T06:11:18Z","timestamp":1774591878000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.70397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/jep.70397"],"URL":"https:\/\/doi.org\/10.1111\/jep.70397","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"value":"1356-1294","type":"print"},{"value":"1365-2753","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70397"}}