Evidence-Based Colorectal Cancer Screening Promotion

Evidence-Based Colorectal Cancer Screening Promotion

Peggy Hannon, PhD, MPHSeptember 24, 2013

This presentation was supported by Cooperative Agreement Number U48DP001911 from the Centers for Disease Control and Prevention. The findings and conclusions in this presentation are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Colorectal Cancer Control Program (CRCCP)Goal: Increase CRC screening to 80% by 2014

Provide screening to un/underinsured

Promote screening population-wide

CRCCP Grantees

Community Guide Strategies

5 strategies to promote CRC screening:

Client-orientedSmall mediaClient remindersReducing structural barriers

Provider-orientedProvider remindersProvider assessment and feedback

Opportunity for CPCRNMission: Accelerate evidence-based intervention (EBI) adoption

Shift in CDC’s approach from NBCCEDP to CRCCP

Grantees urged to use Guide-recommended EBIs

CRCCP Workgroup GoalsStudy EBI adoption, implementation, maintenance

Implement Annual Grantee Survey 2011-2014

Develop additional studies

Annual Grantee Survey

2011: 28 grantees participated (96%)

2012: 29 grantees participated (100%)

2012: Unfunded states/tribes: 24 participated (69%)

2011: Most Grantees Use >1 EBI

Small media

Client re

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Reduc

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5

10

15

20

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3027

21

14

9

14

14

912

5

Currently usesPlans to use

2012: EBI Use Increased

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Reduc

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2011 2012

2012: Grantees Use More EBIs than Unfunded Sites

Small media

Client re

minders

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Provid

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111312

5 64 3

Grantees

Unfunded Sites

Patient NavigationNavigators perform activities related to EBIs

2011: 18 grantees used PN to promote screening

2012: 21 grantees used PN to promote screening

Most common navigator activities

Patient education

Scheduling appointments

Reminder calls for bowel prep or appointments

2012: Grantees Use Other Strategies

Other Strategies N (22)

Provider education/professional development 11

Mass media 8

Quality assurance/quality improvement 8

Group education 7

One-to-one education* 5

Client or provider incentives 4

Other 5

*Added as a Guide-recommended strategy in 2012

2012: Grantees Want Training for Provider-Oriented EBIs

Provider assessment/feedback

Provider reminders

Reducing structural barriers

Client reminders

Small media

0 5 10 15 20 25 30

20

12

16

6

2

N Desiring Training/TA

2012: Other Training/TA Needs

40% or more Grantees wanted training/TA re:

Partnerships with private insurers

Relationships with State Medicare/Medicaid Office

CRC screening data from outside sources

Other Survey TopicsProgram management

CRCCP integration with other programs

CRC screening provision

Data from FQHCs and IHS clinics

CRC screening policies and strategies

Where Are We Now?2013 Annual Survey in the field (Grantees only)

Preparation for 2014 Annual Survey (Grantees & unfunded sites)

In-depth interview study

In-depth InterviewsExplore:

Policy and systems-level EBIs

Partnerships

Transition from providing to promoting screening

13 of 14 interviews completed

Collaboration with CRCCP Program Evaluation TeamDevelop Annual Grantee Survey & additional studies

Data collection, analysis, and interpretation

Integrate survey findings with other evaluation activities

Feedback to grantees (highlights report, webinars)

Broader dissemination

Papers and PresentationsPapersGrantees’ use of EBIs, AJPM, in press

Grantees’ use of patient navigation, under review

Comparison of grantees and unfunded sites, in development Presentations (national meetings)2011 National Colorectal Cancer Roundtable

2012 CDC Cancer Conference

CollaboratorsCPCRN SitesEmoryHarvardUCLAU ColoradoUNCU S. CarolinaU TexasWashington U-St. LouisU Washington

CDCAmy DeGroffLindsay GressardKetra RiceVicki BenardCRCCP Evaluation Team

NCIRuss GlasgowMike SanchezCynthia Vinson

CRCCP Workgroup Co-Chairs

Peggy HannonUniversity of Washingtonpeggyh@uw.edu

Cam EscofferyEmory Universitycescoff@emory.edu

Annette MaxwellUniversity of California at Los Angelesamaxwell@ucla.edu