Sustainability of evidence based interventions implemented in CDC's colorectal cancer control program

The CDC's Colorectal Cancer Control Program (CRCCP) partners with health system clinics to implement evidence-based interventions (EBIs) to increase colorectal cancer (CRC) screening prevalence. The sustainability of those EBIs is critical for the long-term success and impact of the CRCCP. This paper examines various aspects of the sustainability of these EBIs, including the factors associated with sustainability.

We used Clinic Data collected by CDC for program evaluation. The study employed two definitions of sustainability and conducted a comprehensive analysis including all available information on sustainability in the Clinic Data. Our descriptive analysis included comparing frequencies and means of the outcome variable as defined in the study. Logistic regression methods were used to explore the association of multiple explanatory factors with EBI sustainability.

The results highlighted significant variations in the sustainability of different EBIs. Provider reminders were reported as sustainable by 82.0% of the clinics, while reducing structural barriers were reported as sustainable by 55.6% of the clinics. The percentage of clinics able to sustain each of the four EBIs trended upwards over time, ranging from 13 to 34 percentage points increase. Clinics that had implemented EBIs before CRCCP involvement, those that integrated multiple interventions, and those with dedicated screening champions were more likely to sustain EBIs in the long term.

We found substantial improvement in the sustainability of EBIs over the 5-year program period, although results varied by EBIs and room for improvement remains. The findings offer valuable insights for future implementation and sustainability of EBIs.