Primary Care Provider Perceptions of Colorectal Cancer Screening Barriers: Implications for Designing Quality...

Area of Science:

• Health Services Research
• Preventive Medicine
• Oncology

Background:

• Colorectal cancer (CRC) screening rates remain suboptimal.
• Effective interventions require addressing barriers at patient, provider, and system levels.
• Understanding primary care provider (PCP) perceptions of barriers is crucial for designing targeted quality improvement initiatives.

Purpose of the Study:

• To identify distinct groups of PCPs based on their perceptions of CRC screening barriers.
• To examine the relationship between PCP groups and CRC screening rates.
• To inform strategies for barrier assessments preceding intervention design.

Main Methods:

• Retrospective cohort study linking electronic health record (EHR) and survey data.
• Cluster analysis of 166 PCPs (39,430 eligible patients) based on barrier perception survey responses.
• Multivariate logistic regression to predict PCP group membership.

Main Results:

• Two PCP groups emerged: those identifying multiple barriers (N=75) and those identifying none (N=91).
• PCPs in the top half of screening performance were significantly more likely to identify multiple barriers (OR, 4.14; 95% CI, 2.43-7.08).

Conclusions:

• High-performing PCPs demonstrate a greater capacity for identifying CRC screening barriers.
• Targeting high-performing PCPs for barrier assessments offers a novel approach to enhance CRC screening quality improvement interventions.