Anterior–posterior view acquisition during videofluoroscopy: A survey study exploring influential factors on speech-language pathologists’ practice patterns

Purpose: This study explored factors influencing speech-language pathologists’ (SLPs’) decision making surrounding anterior–posterior (AP) view inclusion prac-tices during videofluoroscopic swallowing studies (VFSSs) in the United States. Method: SLPs completing VFSSs were recruited to complete an online anony-mous survey. Questions represented six constructs of interest including: (a) cli-nician demographics, (b) practice patterns, (c) diagnostic perceptions, (d) pro-fessional influences, (e) training and education, and (f) logistical facilitators and barriers. Binary logistic regression was used to explore the relationship between construct items and likelihood of AP view inclusion. Results: A total of 136/213 (64%) of respondents reported obtaining an AP view routinely. Facilitators of AP view inclusion were post-acute work setting (OR =3.40, p =.001); perception that department practices “probably” (OR = 5.65, p =.006) or “definitely” align (OR =5.30, p =.006) with evidence-based practice; perception the AP view has “alot” (OR =4.17, p =.025) or “agreat deal” (OR =4.77, p =.028) of diagnostic value; perception that their department is “definitely” supportive (OR =4.69, p =.040); “moderate” (OR =4.75, p =.001) or “no” (OR =7.51, p <.001) equipment limitations; and radiologist support greater than “extremely unsupportive or resistant” (“somewhat unsupportive” [OR =5.74, p =.041], “neutral” [OR =11.23, p =.002], “somewhat supportive” [OR =13.92, p =.001], or “extremely supportive” [OR =13.92, p =.001]). Barriers to AP view inclusion were geographic location in the southern U.S. census region (OR =0.31, p =.007), being “significantly” influenced by coworker opinions (OR =0.13, p =.018), and productivity tracking (OR =0.21, p =.008). Conclusion: Environmental factors and organizational culture heavily influence AP view inclusion practices.