Facilitating Cancer Screening Improvement Within American Indian Health Systems

Authors:

Anne Walaszek, American Indian Cancer Foundation
Donald Haverkamp (Presenter)
CDC

Kris Rhodes, American Indian Cancer Foundation

Public Health Statement: Colorectal cancer (CRC) incidence is 53% higher for Northern Plains American Indians (AIs) compared to non-Hispanic Whites. Unfortunately screening rates remain low among Northern Plains AIs, ranging from 34% to 47%; CRC screening rates for the U.S. overall are 62%.

Purpose: Findings from the ‘Improving Northern Plains American Indian Colorectal Cancer Screening (INPACS)’ project, conducted by the American Indian Cancer Foundation (AICAF), indicated that AI health systems needed comprehensive, customized approaches to improve CRC screening.

Methods/Approach: AICAF recruited six AI health systems to participate in a Clinical Cancer Screening Network designed to pilot strategies to support CRC screening quality improvement and systems changes.

Strategies to increase screening within AI health systems included—

• Clinic team engagement to identify level of readiness to implement quality improvement efforts.
• Patient and provider education resource and tool development utilizing cues to action and shared decision-making interventions.
• Community education linkages to extend messaging and processes.

Results: AICAF facilitated the identification of current screening processes and determined a customized plan to support clinic goals at each clinic.

Clinics approached CRC screening impact by increasing community/patient/provider awareness, exploring new screening options (stool tests), activating community health representatives and navigating EHR capacity.

Conclusions/Implications: The AICAF Clinical Cancer Screening Network established a framework that can be used by existing screening programs to establish collaborative partnerships with AI health systems to effectively develop and implement evidence-based interventions.