Stakeholder Engagement in Developing an Electronic Clinical Support Tool for Tobacco Prevention in Adolescent Primary Care
Ramzi G. Salloum,
Ryan P. Theis,
Lori Pbert,
Matthew J. Gurka,
Maribeth Porter,
Diana Lee,
Elizabeth A. Shenkman,
Lindsay A. Thompson
Affiliations
Ramzi G. Salloum
Department of Health Outcomes and Biomedical Informatics, and Institute for Child Health Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
Ryan P. Theis
Department of Health Outcomes and Biomedical Informatics, and Institute for Child Health Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
Lori Pbert
Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA
Matthew J. Gurka
Department of Health Outcomes and Biomedical Informatics, and Institute for Child Health Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
Maribeth Porter
Department of Community Health and Family Medicine, College of Medicine, University of Florida, 1600 SW Archer Road, Gainesville, FL 32610, USA
Diana Lee
Odessa Chambliss Center for Health Equity, Bethune-Cookman University, 640 Dr. Mary McLeod Bethune Boulevard, Daytona Beach, FL 32114, USA
Elizabeth A. Shenkman
Department of Health Outcomes and Biomedical Informatics, and Institute for Child Health Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
Lindsay A. Thompson
Department of Health Outcomes and Biomedical Informatics, and Institute for Child Health Policy, College of Medicine, University of Florida, 2004 Mowry Road, Gainesville, FL 32610, USA
Following guideline recommendations to promote tobacco prevention in adolescent primary care, we developed a patient-facing clinical support tool. The electronic tool screens patients for use and susceptibility to conventional and alternative tobacco products, and promotes patient⁻provider communication. The purpose of this paper is to describe the iterative stakeholder engagement process used in the development of the tool. During the pre-testing phase, we consulted with scientists, methodologists, clinicians, and Citizen Scientists. Throughout the development phase, we engaged providers from three clinics in focus groups. Usability testing was conducted via in-depth, cognitive interviewing of adolescent patients. Citizen Scientists (n = 7) played a critical role in the final selection of educational content and interviewer training by participating in mock-up patient interviews. Cognitive interviews with patients (n = 16) ensured that systems were in place for the feasibility trial and assessed ease of navigation. Focus group participants (n = 24) offered recommendations for integrating the tool into clinical workflow and input on acceptability and appropriateness, and anticipated barriers and facilitators for adoption and feasibility. Engaging key stakeholders to discuss implementation outcomes throughout the implementation process can improve the quality, applicability, and relevance of the research, and enhance implementation success.
