Implementation of a work-related asthma screening questionnaire in clinical settings: A multi-methods study

JMIR Form Res. 2022 Aug 10. doi: 10.2196/37503. Online ahead of print.


BACKGROUND: A work-related asthma screening questionnaire is currently being validated for implementation in clinical settings. In order to minimize barriers in integrating tools into clinical practice, discussion of strategies for implementation of the questionnaire have begun.

OBJECTIVE: We aimed to understand the benefits, feasibility, barriers and limitations to implementing the Work-related Asthma Screening Questionnaire (Long-version)(WRASQ(L))TM, and asthma eTools in clinical settings and propose dissemination and implementation strategies for the WRASQ(L)TM.

METHODS: This study took place in Kingston, ON, Canada from September 2019 to August 2021. A workshop and two questionnaires were used to understand the benefits and barriers to implementing the questionnaire in clinical settings. An expert advisory committee was established to generate implementation and dissemination strategies. Workshops were semi-structured and used thematic qualitative analysis to identify themes that provide an understanding of the benefits, limitations, and barriers to using the WRASQ(L)TM, and eTools in general, in clinical settings. Workshop participants included a patient and healthcare providers, including physicians, nurses, and asthma educators, who were implementation specialists and expert EMR users. One questionnaire focused on providers’ knowledge and awareness of work-related asthma and one focused on WRASQ(L)TM feedback were administered at the workshops. Advisory committee members from relevant stakeholders met three times to strategize implementation opportunities.

RESULTS: Six themes were identified in the workshop: (a) involve and address patient needs; (b) novel data collection; (c) knowledge translation; (d) time considerations; (e) functional/practical barriers; and (f) human limitations. Questionnaire responses yielded positive feedback on the utility of the WRASQ(L)TM in clinical settings. All participants agreed it is an easy way to collect information on occupational and exposure history, and could prompt a discussion between the healthcare provider and patient on how the workplace and exposures could affect one’s asthma, increase awareness of WRA in patients and providers, and increase awareness of exposures in the workplace Implementation and dissemination strategies were generated with input from the advisory committee.

CONCLUSIONS: Stakeholders and workshop participants consider the WRASQ(L)TM to be a useful tool that satisfies many needs of providers in their clinical settings. Once validated, dissemination strategies will include developing educational material that includes the WRASQ(L)TM, linking the questionnaire to stakeholder websites/eToolkits, translation into other languages, leveraging healthcare and research network, conference presentations and peer-reviewed publications. Implementation strategies will include integration into EMRs, designing multifaceted interventions, and targeting non-traditional settings such as workplaces, pharmacies and research settings. The WRASQ(L)TM addresses many benefits and barriers to implementation as identified in the workshop themes. These themes will guide future implementation and dissemination strategy, with note that human limitations identified in providers and patients will need to be overcome for a successful implementation.

PMID:35964327 | DOI:10.2196/37503

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