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Evaluating Uptake of Evidence-Based Interventions in 355 Clinics Partnering With the Colorectal Cancer Control
Annette E Maxwell1,2, Amy DeGroff3, Sarah D Hohl4
1University of California Los Angeles, Los Angeles, California.
Preventing Chronic Disease
|May 19, 2022
Summary
The Colorectal Cancer Control Program (CRCCP) increased use of electronic health record-integrated interventions for colorectal cancer screening. Uptake of patient navigation and community health workers remained low, highlighting a need for further research.
Area of Science:
- Public Health
- Health Services Research
- Cancer Prevention
Background:
- Colorectal cancer screening rates in the US are suboptimal.
- The Centers for Disease Control and Prevention (CDC) established the Colorectal Cancer Control Program (CRCCP) to improve screening.
- This program aimed to increase screening in health system clinics using evidence-based interventions (EBIs) and supporting activities (SAs).
Purpose of the Study:
- To assess the uptake and integration of EBIs and SAs in 355 clinics participating in the CRCCP from 2015 to 2018.
- To evaluate the perceived sustainability of implemented strategies.
Main Methods:
- 30 CRCCP awardees partnered with clinics to implement prioritized EBIs and optional SAs.
- Clinics completed annual surveys over three years to report on strategy uptake, implementation, integration, and sustainability.
- EBIs included patient/provider reminders, reducing structural barriers, and provider assessment/feedback.
- SAs included small media, professional development, patient navigation, and community health workers.
Main Results:
- Uptake of four EBIs and two SAs significantly increased over the study period.
- By year 3, high implementation rates were observed for patient reminders (82%), provider reminders (88%), provider assessment/feedback (82%), reducing structural barriers (76%), and small media (84%).
- Provider education reached 51% of clinics, while patient navigation (30%) and community health workers (19%) showed no increase.
- Over 90% of clinics considered implemented strategies fully integrated and sustainable by year 3.
Conclusions:
- Clinics demonstrated high uptake and perceived sustainability for EBIs integrated into electronic medical records.
- Limited uptake of patient navigation and community health workers suggests a need for strategies to promote these interventions, which are crucial for reducing cancer disparities.
- Further research is needed to optimize CRCCP interventions and assess their cost-effectiveness.
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