NDLI: Methods for scaling up an outreach intervention to increase colorectal cancer screening rates in rural areas

Content Provider	Springer Nature : BioMed Central
Author	Coury, Jennifer Coronado, Gloria Currier, Jessica J. Kenzie, Erin S. Petrik, Amanda F. Badicke, Brittany Myers, Emily Davis, Melinda M.
Abstract	Background Mailed fecal immunochemical test (FIT) outreach and patient navigation are evidence-based practices shown to improve rates of colorectal cancer (CRC) and follow-up in various settings, yet these programs have not been broadly adopted by health systems and organizations that serve diverse populations. Reasons for low adoption rates are multifactorial, and little research explores approaches for scaling up a complex, multi-level CRC screening outreach intervention to advance equity in rural settings. Methods SMARTER CRC, a National Cancer Institute Cancer Moonshot project, is a cluster-randomized controlled trial of a mailed FIT and patient navigation program involving 3 Medicaid health plans and 28 rural primary care practices in Oregon and Idaho followed by a national scale-up trial. The SMARTER CRC intervention combines mailed FIT outreach supported by clinics, health plans, and vendors and patient navigation for colonoscopy following an abnormal FIT result. We applied the framework from Perez and colleagues to identify the intervention’s components (including functions and forms) and scale-up dissemination strategies and worked with a national advisory board to support scale-up to additional organizations. The team is recruiting health plans, primary care clinics, and regional and national organizations in the USA that serve a rural population. To teach organizations about the intervention, activities include Extension for Community Healthcare Outcomes (ECHO) tele-mentoring learning collaboratives, a facilitation guide and other materials, a patient navigation workshop, webinars, and individualized technical assistance. Our primary outcome is program adoption (by component), measured 6 months after participation in an ECHO learning collaborative. We also assess engagement and adaptations (implemented and desired) to learn how the multicomponent intervention might be modified to best support broad scale-up. Discussion Findings may inform approaches for adapting and scaling evidence-based approaches to promote CRC screening participation in underserved populations and settings. Trial registration Registered at ClinicalTrials.gov (NCT04890054) and at the NCI’s Clinical Trials Reporting Program (CTRP no.: NCI-2021–01032) on May 11, 2021.
Related Links	https://implementationsciencecomms.biomedcentral.com/counter/pdf/10.1186/s43058-023-00540-1.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	26622211
DOI	10.1186/s43058-023-00540-1
Journal	Implementation Science Communications
Issue Number	1
Volume Number	5
Language	English
Publisher	BioMed Central
Publisher Date	2024-01-08
Access Restriction	Open
Subject Keyword	Health Services Research Public Health Health Policy Health Administration Health Promotion and Disease Prevention Colorectal cancer screening Mailed fecal immunochemical testing Patient navigation Scaling-up interventions Implementation science Rural health Multilevel intervention
Content Type	Text
Resource Type	Article
Subject	Health Policy Public Health, Environmental and Occupational Health Health Informatics

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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Mailed fecal testing and patient navigation versus usual care to improve rates of colorectal cancer screening and follow-up colonoscopy in rural Medicaid enrollees: a cluster-randomized controlled trial

Correction: Methods for scaling up an outreach intervention to increase colorectal cancer screening rates in rural areas

Health plan adaptations to a mailed outreach program for colorectal cancer screening among Medicaid and Medicare enrollees: the BeneFIT study

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

Implementing Mailed Colorectal Cancer Fecal Screening Tests in Real-World Primary Care Settings: Promising Implementation Practices and Opportunities for Improvement.

Implementation strategies in the Exploration and Preparation phases of a colorectal cancer screening intervention in community health centers

What implementation interventions increase cancer screening rates? a systematic review

Centralized colorectal cancer screening outreach and patient navigation for vulnerable populations in North Carolina: study protocol for the SCORE randomized controlled trial

Source matters: a survey of cost variation for fecal immunochemical tests in primary care

Methods for scaling up an outreach intervention to increase colorectal cancer screening rates in rural areas

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Mailed fecal testing and patient navigation versus usual care to improve rates of colorectal cancer screening and follow-up colonoscopy in rural Medicaid enrollees: a cluster-randomized controlled trial

Correction: Methods for scaling up an outreach intervention to increase colorectal cancer screening rates in rural areas

Health plan adaptations to a mailed outreach program for colorectal cancer screening among Medicaid and Medicare enrollees: the BeneFIT study

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

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