Cross‐sectional survey study of primary care clinics on evidence‐based colorectal cancer screening intervention use

2021 ◽  
Author(s):  
Shinobu Watanabe‐Galloway ◽  
Jungyoon Kim ◽  
Frantzlee LaCrete ◽  
Kaeli Samson ◽  
Jason Foster ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Survey Study ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Primary Care Clinics

Primary Care Providers' Attitudes Towards Recommending Cancer Screening to Patients With Intellectual Disability: A Cross-Sectional Survey

Inclusion ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 185-193
Author(s):  
Genevieve Breau ◽  
Sally Thorne ◽  
Jennifer Baumbusch ◽  
T. Greg Hislop ◽  
Arminee Kazanjian
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Intellectual Disability ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Primary Care Providers ◽  
Survey Study ◽  
Care Providers ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Individuals with intellectual disability (ID) obtain breast, cervical, and colorectal cancer screening at lower rates, relative to the general population. This cross-sectional survey study explored how primary care providers and trainees recommend cancer screening to patients with ID, using a standardized attitudes questionnaire and vignettes of fictional patients. In total, 106 primary care providers and trainees participated. Analyses revealed that participants' attitudes towards community inclusion predicted whether participants anticipated recommending breast and colorectal cancer screening to fictional patients. Further research is needed to explore these factors in decisions to recommend screening, and how these factors contribute to cancer screening disparities.

scholarly journals Development of a multilevel intervention to increase colorectal cancer screening in Appalachia

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Aaron J. Kruse-Diehr ◽  
Jill M. Oliveri ◽  
Robin C. Vanderpool ◽  
Mira L. Katz ◽  
Paul L. Reiter ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
The United States ◽  
Advisory Board ◽  
Community Advisory Board ◽  
Primary Care Clinics ◽  
Crc Screening ◽  
Multilevel Intervention

Abstract Background Colorectal cancer (CRC) screening rates are lower in Appalachian regions of the United States than in non-Appalachian regions. Given the availability of various screening modalities, there is critical need for culturally relevant interventions addressing multiple socioecological levels to reduce the regional CRC burden. In this report, we describe the development and baseline findings from year 1 of “Accelerating Colorectal Cancer Screening through Implementation Science (ACCSIS) in Appalachia,” a 5-year, National Cancer Institute Cancer MoonshotSM-funded multilevel intervention (MLI) project to increase screening in Appalachian Kentucky and Ohio primary care clinics. Methods Project development was theory-driven and included the establishment of both an external Scientific Advisory Board and a Community Advisory Board to provide guidance in conducting formative activities in two Appalachian counties: one in Kentucky and one in Ohio. Activities included identifying and describing the study communities and primary care clinics, selecting appropriate evidence-based interventions (EBIs), and conducting a pilot test of MLI strategies addressing patient, provider, clinic, and community needs. Results Key informant interviews identified multiple barriers to CRC screening, including fear of screening, test results, and financial concerns (patient level); lack of time and competing priorities (provider level); lack of reminder or tracking systems and staff burden (clinic level); and cultural issues, societal norms, and transportation (community level). With this information, investigators then offered clinics a menu of EBIs and strategies to address barriers at each level. Clinics selected individually tailored MLIs, including improvement of patient education materials, provision of provider education (resulting in increased knowledge, p = .003), enhancement of electronic health record (EHR) systems and development of clinic screening protocols, and implementation of community CRC awareness events, all of which promoted stool-based screening (i.e., FIT or FIT-DNA). Variability among clinics, including differences in EHR systems, was the most salient barrier to EBI implementation, particularly in terms of tracking follow-up of positive screening results, whereas the development of clinic-wide screening protocols was found to promote fidelity to EBI components. Conclusions Lessons learned from year 1 included increased recognition of variability among the clinics and how they function, appreciation for clinic staff and provider workload, and development of strategies to utilize EHR systems. These findings necessitated a modification of study design for subsequent years. Trial registration Trial NCT04427527 is registered at https://clinicaltrials.gov and was registered on June 11, 2020.

scholarly journals Assessing Levels and Correlates of Implementation of Evidence-Based Approaches for Colorectal Cancer Screening: A Cross-Sectional Study With Federally Qualified Health Centers

2018 ◽  
Vol 45 (6) ◽  
pp. 1008-1015 ◽  
Author(s):  
Timothy J. Walker ◽  
Betsy Risendal ◽  
Michelle C. Kegler ◽  
Daniela B. Friedman ◽  
Bryan J. Weiner ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Medical Record ◽  
Colorectal Cancer Screening ◽  
Implementation Strategies ◽  
Health Centers ◽  
Evidence Based ◽  
Federally Qualified Health Centers ◽  
Record System ◽  
Cross Sectional

Multiple evidence-based approaches (EBAs) exist to improve colorectal cancer screening in health clinics. The success of these approaches is tied to effective implementation. Therefore, the purpose of this study was to assess the implementation of EBAs for colorectal cancer screening and clinic-level correlates of implementation in federally qualified health centers (FQHCs). We conducted descriptive and cross-sectional analyses using data collected from FQHC clinics across seven states ( n = 51). A clinic representative completed electronic surveys about clinic characteristics (e.g., size, patient characteristics, and medical record system characteristics) and the implementation of Community Guide recommended EBAs (e.g., client reminders, small media, and provider assessment and feedback). We used bivariate Spearman correlations to assess clinic-level correlates with implementation outcomes. Most clinics were planning to implement, in the early implementation stages, or inconsistently implementing EBAs. No EBA was fully implemented by more than nine (17.6%) clinics. Clinic size variables were inversely related to implementation levels of one-on-one education; medical record variables were directly related to implementation levels of client and provider reminders as well as provider assessment and feedback; and rapid and timely feedback from clinic leaders was directly associated with implementation levels of four out of six EBAs. Given the varying levels of implementation, clinics need to assess current use of implementation strategies and improve effective program delivery to increase colorectal cancer screening among their patients. In addition, clinics should also consider how their characteristics may support or serve as a barrier to implementation in their respective settings.

scholarly journals Developing a Co-Production Strategy to Facilitate the Adoption and Implementation of Evidence-Based Colorectal Cancer Screening Interventions for Rural Health Systems: A Pilot Study

2021 ◽  
Author(s):  
Jungyoon Kim ◽  
Paul Estabrooks ◽  
Alisha Aggarwal ◽  
Analisa McMillan ◽  
Khalid Alshehri
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Implementation Strategies ◽  
Systems Change ◽  
Content Delivery ◽  
Evidence Based ◽  
Rural Primary Care ◽  
Adoption And Implementation

Abstract Background: Evidence-based colorectal cancer screening (CRCS) interventions exist, but have not been broadly adopted in rural primary care settings. Participatory adoption and implementation strategies may be promising in closing this gap through a clinical-academic partnership to guide rural practitioners to locate, select, and implement CRCS interventions that align with local context. We developed a prototype strategy adapted from the National Cancer Institute’s ‘Putting Public Health Evidence in Action’ curriculum in collaboration with two rural clinics to facilitate systems change related to CRCS. This paper describes the process of co-development and delivery of a systems-focused strategy to improve adoption, implementation, and sustainability of CRCS interventions. Methods: We used a bundle of implementation strategies with a core focus on academic-clinical partnership development and Plan-Do-Study-Act cycles to identify clinical partner interests/preferences on delivery methods and content needed to facilitate intervention identification and systems-change processes that improve CRCS rates. Clinic physicians and staff (n=7) at the rural clinics were asked to evaluate the approach based on overall reactions and perceptions of innovation characteristics using 5-point Likert scale. After completing the systems-change process, we conducted key-stakeholder interviews (n=5) to assess feasibility and acceptability on content/delivery format and plans for ongoing implementation of CRCS evidence-based interventions (EBIs). Results: Electronic blueprints for CRCS EBI selection and implementation (8 modules) were developed and followed by an online forum/live-streaming conference to allow for CRCS tailoring. The two clinics used different learning approaches: one completed the modules together while the other completed the modules separately to cover material before a group video conference. Across all modules, participants in both clinics reported positive reactions toward the systems-change modules. Both clinics reported improvements in how they perceived the characteristics of the modules and the participatory approach to tailor selected CRCS EBIs. Through the process both clinics developed a specific EBI implementation plan. Interview participants reported that the approach was feasible and acceptable, and provided suggestions for further improvements on content, delivery, and format of the approach.Conclusions: The bundle of implementation strategies used were feasible and acceptable in rural primary care practices to facilitate the use of evidence-based approaches to improve CRCS.

scholarly journals Developing a Co-Production Strategy to Facilitate the Adoption and Implementation of Evidence-Based Colorectal Cancer Screening Interventions for Rural Health Systems: A Pilot Study

2021 ◽  
Author(s):  
Jungyoon Kim ◽  
Paul Estabrooks ◽  
Alisha Aggarwal ◽  
Analisa McMillan ◽  
Khalid Alshehri
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Implementation Strategies ◽  
Systems Change ◽  
Content Delivery ◽  
Evidence Based ◽  
Rural Primary Care ◽  
Adoption And Implementation

Abstract Background: Evidence-based colorectal cancer screening (CRCS) interventions exist, but have not been broadly adopted in rural primary care settings. Participatory adoption and implementation strategies may be promising in closing this gap through a clinical-academic partnership to guide rural practitioners to locate, select, and implement CRCS interventions that align with local context. We developed a prototype strategy adapted from the National Cancer Institute’s ‘Putting Public Health Evidence in Action’ curriculum in collaboration with two rural clinics to facilitate systems change related to CRCS. This paper describes the process of co-development and delivery of a systems-focused strategy to improve adoption, implementation, and sustainability of CRCS interventions. Methods: We used a bundle of implementation strategies with a core focus on academic-clinical partnership development and Plan-Do-Study-Act cycles to identify clinical partner interests/preferences on delivery methods and content needed to facilitate intervention identification and systems-change processes that improve CRCS rates. Clinic physicians and staff (n=7) at the rural clinics were asked to evaluate the approach based on overall reactions and perceptions of innovation characteristics using 5-point Likert scale. After completing the systems-change process, we conducted key-stakeholder interviews (n=5) to assess feasibility and acceptability on content/delivery format and plans for ongoing implementation of CRCS evidence-based interventions (EBIs). Results: Electronic blueprints for CRCS EBI selection and implementation (8 modules) were developed and followed by an online forum/live-streaming conference to allow for CRCS tailoring. The two clinics used different learning approaches: one completed the modules together while the other completed the modules separately to cover material before a group video conference. Across all modules, participants in both clinics reported positive reactions toward the systems-change modules. Both clinics reported improvements in how they perceived the characteristics of the modules and the participatory approach to tailor selected CRCS EBIs. Through the process both clinics developed a specific EBI implementation plan. Interview participants reported that the approach was feasible and acceptable, and provided suggestions for further improvements on content, delivery, and format of the approach.Conclusions: The bundle of implementation strategies used were feasible and acceptable in rural primary care practices to facilitate the use of evidence-based approaches to improve CRCS.

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