Protocol paper for an implementation science approach to promoting colorectal cancer screening in Federally Qualified Health Center clinics: A stepped-wedge, multilevel intervention trial.

Author:

Montoya CPH CHES MPH Samantha M.1,Olaore CPH MPH MBChB Pelumi2,Bastardo-Acosta 2,Abdulla MA Rania1,Schell Michael J.1,Hidalgo Allan3,Turner BSN RN Barbara3,Rider DO Monica4,Kishun-Jit Nirmala4,Joshua Ashlon4,Pollard Jennifer4,Friedman Mark1,Christy Shannon M.1,Meade 1,Gwede 1

Affiliation:

1. Moffitt Cancer Center

2. University of South Florida

3. Central Florida Health Care

4. MCR Health

Abstract

Abstract

Background Colorectal cancer is the third leading cause of cancer-related deaths in the United States. Despite the Healthy People 2030 goal of 70.5%, colorectal cancer (CRC) screening rates in Federally Qualified Health Centers (FQHCs) are suboptimal at about 40%. The Colorectal Cancer Awareness, Research, Education and Screening-Rural Expansion, Access, and Capacity for Health (CARES-REACH) study seeks to address this disparity and accelerate the adoption and utilization of effective, evidence-based CRC screening practices. This paper describes the CARES-REACH study design and implementation methods. Methods Informed by a community-based participatory research (CBPR) framework and enriched by implementation science approaches, CARES-REACH features a stepped wedge design with extension for maintenance to support an implementation strategy focused on multiple levels: organizational, provider, and patient levels that entail processes to boost initial and repeat screening among average risk and age-eligible adults. This multilevel study entails the implementation of a core set of evidence-based interventions (EBIs) that include low literacy patient education (English, Spanish, and Haitian Creole language); provider education, system-wide electronic medical record (EMR) tools including provider prompts and patient reminders, FIT (fecal immunochemical test) kit distribution, plus an organization-wide cancer control champion who motivates providers, coaches and navigates patients, and monitors system-wide CRC screening activities. Trial Registration NCT04464668.

Publisher

Springer Science and Business Media LLC

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