Characterizing screening champions in the center for disease control and prevention's Colorectal Cancer Control...

Area of Science:

• Public Health
• Health Services Research
• Cancer Control

Background:

• The CDC's Colorectal Cancer Control Program (CRCCP) utilizes evidence-based interventions (EBIs) to increase colorectal cancer (CRC) screening.
• Program champions are crucial for facilitating EBI implementation and driving change within healthcare systems.
• Limited understanding of champion roles and sustainability in clinical settings necessitates further investigation.

Purpose of the Study:

• To investigate the types, roles, and sustainability of program champions within the CRCCP.
• To identify factors contributing to champion stability and effectiveness in promoting CRC screening.

Main Methods:

• A mixed-methods, cross-sectional study combining surveys from 205 health system and clinic staff (representing 303 clinics) and 12 qualitative interviews.
• Surveys assessed clinic characteristics, EBI implementation, champion information, and sustainability.
• Interviews explored champion roles, benefits, turnover, and maintenance strategies.

Main Results:

• Champions were identified at health system (QI managers, physicians, administrators) and clinic levels (physicians, QI managers, medical assistants).
• Naturally emerging champions, particularly in clinics, demonstrated greater stability (zero turnover) compared to assigned champions.
• Champion roles included advocacy, technical assistance, policy development, and quality improvement oversight for CRC screening.

Conclusions:

• Naturally emerging champions exhibit superior stability compared to assigned champions, offering valuable insights for public health program design.
• Findings inform the strategic use of program champions to enhance clinic-based public health initiatives, particularly for cancer screening.
• Sustaining champions requires strong leadership support, program adaptability, and robust organizational capacity.