Multilevel Interventions to Improve Colorectal Cancer Screening in an Urban Native American Community: A Pilot...

Area of Science:

• Public Health
• Oncology
• Health Disparities

Background:

• Native Americans experience the highest colorectal cancer (CRC) burden and lowest screening rates in the U.S.
• Pandemic exacerbated existing CRC screening disparities, highlighting the need for effective interventions.

Purpose of the Study:

• To evaluate an organized, multilevel outreach program aimed at increasing CRC screening completion among Native Americans.
• To identify barriers and facilitators to CRC screening and the implemented outreach program using the Consolidated Framework for Implementation Research (CFIR).

Main Methods:

• Pilot randomized controlled trial comparing an organized outreach program to usual care for CRC screening.
• Outreach program included patient identification via health records, mailed FIT kits, reminders, and navigation to colonoscopy.
• Patient and provider interviews were conducted to explore implementation factors.

Main Results:

• The organized outreach program demonstrated improved completion of colorectal cancer screening.
• Qualitative data provided insights into barriers and facilitators influencing screening uptake and program implementation.

Conclusions:

• Multilevel, organized outreach interventions are effective in improving CRC screening completion in Native American communities.
• Understanding implementation factors through frameworks like CFIR is crucial for successful public health interventions.