Overall approach
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Appropriateness
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Appropriate for rural practice, acceptable, helpful and educational
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“I think it would be a great tool for our rural areas; that don't have that opportunity to get their numbers up or are not aware of the importance of that and trying to get their numbers up in the colorectal cancer screening. I thought they were well presented and, were very well done.“ – Referral coordinator.
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Video contents and presentation
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Video content
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Relevant and easy to understand; but some parts were redundant
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“The presentations as far as walking us through the videos and the information that you provided, it was all relevant and easy to understand” – Certified case manager.
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Video presentation
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Tone was too monotonous, but improved after initial feedback
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“The voiceover in the video, the monologue, was difficult to follow. But, after we gave you guys that feedback, since that time they've all been great” - Certified case manager.
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Live-streaming conference
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Conversation
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Initiate's conversation relevant to CRC screening; Beneficial to touch base with others (providers/staff at clinic)
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“I like that we do the conversation afterwards because, you know, even if we don't necessarily talk about everything that we learned in the video, it often sparked conversation relevant” - Certified case manager.
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facilitation
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Good facilitation/feedback/support from research team
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“I think that they were helpful. It's nice to get feedback on what you have discussed amongst your own group with – with other people. And I think that's a good thing to do” - Referral coordinator
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Tools/ resources
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Usefulness
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Template, websites, and handouts were useful
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“I really liked those handouts that were attached to the portal. Those different Websites were great. You know, something that we weren't using before” - Director of Care Coordination
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Adaptability
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Templates were easily modified/compatible by clinic teams
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“The templates and stuff were really helpful. We could print those off and come up with a plan that we thought would work and then present it and see what your thoughts were” - Referral coordinator
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Format
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Provider participation
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Having providers (MDs/PAs/NPs) in the team was helpful to get buy-in’s, actions followed, and feedback on feasibility and resources
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“Having the opportunity to talk to the providers and getting their feedback of what's going to work and what's not going to work, what's realistic in real-life practice and just hearing their side of what resources and tools they might need” - Certified case manager.
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Monthly session
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Monthly interval was appropriate, and helps keep the conversations going; monthly reminder was helpful
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“I think for us in this office, the monthly was the best way to do it” – Referral coordinator.
“Just the fact that we are taking the time out of our schedule to talk about it and brainstorm ways to do things, I think that was a great benefit.” – Certified case manager.
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Delivery
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Learning management system
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Half of the participants adopted the software; the other half preferred email; online discussion board was not used by all participants
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“I did not like the discussion boards. I didn't feel like they were very helpful to me.” – Director of care coordination
“I think having sent out the specific links was great because, you get busy, and you're like, I don't remember where we are at?” - Certified case manager
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Reminder
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Weekly reminder was helpful for individual learning
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“I thought that was a good format. Sometimes I would get busy and forget about them. So the weekly reminders were really helpful” – Referral coordinator
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Scheduling
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scheduling for live conference was challenging
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“I think the main challenge that I guess I had was just getting everybody's work schedules to work and getting everybody to respond back. I know we had sometimes where it's like, I'm trying to get this on the schedule, but it's not working” – Certified case manager
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Suggestions
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Discrepancy about potential participants for future training
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Only providers should be involved, and other staff can be included occasionally
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“I think just having the providers there is the best.” - Certified case manager
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Nurses, scheduling staff, chronic care management team should be included; MA and CNAs should be involved.
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“I really think it starts with just the demeanor of the front staff checking them in. You know, maybe giving them a handout or starting that conversation
comes way before that doctor” – Director of care coordination.
“I'd like to see the bulk of the nurses trained to use them. But right now, I'd like to really see the chronic care managers get involved and use them” – Physician.
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Improvements in delivery
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Sending information in advance; removing online discussion board unless more interactive
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“The only other suggestion I would have is maybe send out –if we do a month apart on the modules, maybe send the modules out maybe two weeks in advance or a little bit earlier just to have time just in case you have downtime at the clinic to watch it.” – Certified case manager
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Improvements in video content
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remove redundancy from the video lecture (e.g., basic definitions, repeated examples of EBIs)
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“The only thing would be making it a little less; the nurses did complain that it was a little redundant.” – Physician
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