本研究比较了多个卫生系统（其中一些有两个或多个不同的 UTS 计划）的林奇综合征通用肿瘤筛查 (UTS)，以了解可能影响复杂计划成功实施的多层次因素。使用了来自 66 个利益相关者访谈的数据进行多值重合分析 (mv-CNA)，并确定始终对 UTS 计划是否在系统级别实施和优化产生影响的关键因素。所选 CNA 模型揭示了区分 4 个优化 UTS 计划的条件组合，10未优化程序，4个系统无程序。完全优化的悉尼科技大学项目既有维护冠军，也有积极的内部环境。两条独立的路径是非优化计划所特有的：1）积极的态度和混合的内部环境，或 2）有限的计划

This study compared Lynch syndrome universal tumor screening (UTS) across multiple health systems (some of which had two or more distinct UTS programs) to understand multi-level factors that may impact the successful implementation of complex programs.Data from 66 stakeholder interviews were used to conduct multi-value coincidence analysis (mv-CNA) and identify key factors that consistently make a difference in whether UTS programs were implemented and optimized at the system level.The selected CNA model revealed combinations of conditions that distinguish 4 optimized UTS programs, 10 non-optimized programs, and 4 systems with no program. Fully optimized UTS programs had both a maintenance champion and a positive inner setting. Two independent paths were unique to non-optimized programs: 1) positive attitudes and a mixed inner setting, or 2) limited planning & engaging among stakeholders. Negative views about UTS evidence or lack of knowledge about UTS led to a lack of planning and engaging, which subsequently prevented program implementation.The model improved our understanding of program implementation in health care systems and informed the creation of a toolkit to guide UTS implementation, optimization, and changes. Our findings and toolkit may serve as a use case to increase the successful implementation of other complex precision health programs.Copyright © 2024. Published by Elsevier Inc.