Using a Matrixed Multiple Case Study Approach to Identify Factors Impacting Successful Hereditary Cancer Screening Implementation in Primary Care

Abstract

Genetic testing can be used to identify those at risk for hereditary cancers for which lifesaving preventative interventions may be available. Despite the potential benefit that can come from this type of genetic testing, it is not often conducted in a primary care setting. Therefore, there is interest in implementing genetic testing for hereditary cancer risk more broadly. The EDGE trial previously studied implementing hereditary cancer risk assessment and genetic testing in a primary care setting. However, this prior research focused mainly on individual factors that may impact implementation success. The present study expands on EDGE by examining what multi-level factors may have impacted uptake of hereditary cancer risk assessment and genetic testing in this trial. For analysis, we used a matrixed multiple case study approach and found 7 factors that had clear impacts on implementation success. These findings provide important context on what is most important to the success of hereditary cancer screening implementation programs.