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
minders
Reduc
ing stru
ctura
l barrie
rs
Provid
er re
minders
Provid
er ass
ess/f
eedba
ck0
5
10
15
20
25
3027
21
14
9
14
14
912
5
Currently usesPlans to use
2012: EBI Use Increased
Small media
Client re
minders
Reduc
ing stru
ctura
l barrie
rs
Provid
er re
minders
Provid
er ass
ess/f
eedba
ck0
5
10
15
20
25
3027
21
14
9
14
28
22
17
1113
2011 2012
2012: Grantees Use More EBIs than Unfunded Sites
Small media
Client re
minders
Reduc
ing stru
ctura
l barrie
rs
Provid
er re
minders
Provid
er ass
ess/f
eedba
ck0
5
10
15
20
25
30 28
22
17
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 [email protected]
Cam EscofferyEmory [email protected]
Annette MaxwellUniversity of California at Los [email protected]
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