Symposia
Dissemination & Implementation Science
Nicole A. Stadnick, M.P.H., Ph.D. (she/her/hers)
Assistant Professor
University of California San Diego
La Jolla, California
Kelli Cain, MS (she/her/hers)
Project Manager
University of California San Diego
La Jolla, California
Lawrence Ayers, B.A.
Research Assistant
University of California, San Diego
La Jolla, California
Angel Lomeli, B.A.
Research Assistant
University of California San Diego
La Jolla, California
Arleth Escoto, B.A.
Research Assistant
University of California San Diego
La Jolla, California
Maria Linda Burola, MS
Research Assistant
University of California San Diego
La Jolla, California
Stephenie Tinoco Calvillo, B.A.
Research Assistant
University of California San Diego
La Jolla, California
Breanna Reyes, B.A.
Research Assistant
University of California San Diego
La Jolla, California
Linda Salgin, MPH
Program Manager
San Ysidro Health
San Diego, California
Robert Tukey, PhD
Professor
University of California San Diego
La Jolla, California
Louise Laurent, MD
Professor
University of California San Diego
La Jolla, California
Borsika Rabin, PhD, PharmD, MPH
Associate Professor
University of California San Diego
La Jolla, California
Introduction: Meaningful community engagement to co-create health programs can promote the uptake, sustained implementation, broad reach, and effectiveness of these programs. This is particularly important for programs prioritizing underserved communities because resources are often limited. Brainwriting premortem is a novel, participatory qualitative approach that combines individual brainstorming with the concept of premortem reflection to addresses potential failure points prior to program implementation.
Methods: Brainwriting premortem was adapted and used to iteratively refine a COVID-19 testing program offered at a federally qualified health center (FQHC) near the US/Mexico border. Patients and providers from the FQHC participated in 30-minute interviews during early- and mid-implementation of the program. Qualitative data were transcribed, translated, and analyzed using a rapid qualitative approach.
Results: A total of 11 patients (7 Spanish- and 4 English-speaking) and 8 providers completed brainwriting premortem interviews. Key themes about possible failures of the COVID-19 testing program failure were: advertising/sharing information; access to testing; handling of test results; staff and patient safety; patient beliefs regarding the SARS-CoV-2 virus; and available COVID-19 testing options. Proposed solutions were offered for each key failure except for patient beliefs regarding the SARS-CoV-2 virus. Additional solutions included education, physical operations, and recruitment strategies. Real-time changes to the program were made in response to 7 suggestions from patients and 11 suggestions from providers. Actual changes related to returning test results were the most common, and included emailing results with distinct workflows based on the test result.
Conclusion: This work demonstrates the utility of an adapted version of the brainwriting premortem technique to iteratively refine a COVID-19 testing program at a FQHC serving a US/Mexico border community. Future research, particularly those requiring rapid response to public health emergencies, should consider the use of this participatory technique.
