A Multifaceted, Intensive Approach to Facilitate System Change for Colorectal Cancer Screening

Authors:

Stephenie Kennedy, West Virginia University
Mary Ellen Conn (Presenter)
West Virginia University

Susan Eason, West Virginia University
Dannell Boatman, West Virginia University
Taylor Daugherty, West Virginia University
Adam Baus, West Virginia University
Cecil Pollard, West Virginia University

Public Health Statement: Colorectal cancer (CRC) in West Virginia (WV) is a significant health problem being the second leading cause of cancer-related deaths.

Purpose: Evidence-based interventions (EBIs) increase CRC screening. Implementing in the primary care setting is challenging with competing health priorities. The WV Program to Increase Colorectal Cancer Screening facilitates practice-based change in health systems with the goal of increasing their screening rate to 80% or at least 10% over baseline.

Methods/Approach: 16 clinics participated in a two-year, two-phase partnership. Year one provided intensive technical assistance to implement 2-3 EBIs and supportive activities. 81 providers received quarterly provider assessment and feedback. An enhanced client reminder system using Stages of Change health theory called patients to provide tailored messaging for them to complete a fecal immunochemical test (FIT). Small media materials were developed for each clinic’s population. Additional program support was provided through professional education of providers and staff on CRC screening guidelines, EBIs, and motivational interviewing. In year two clinics continued implementing EBIs with reduced technical assistance.

Results: Screening rates increased among all clinics. Mean screening rates increased from 28% to 51%. Mean provider screening rates increased from 30% to 50%. The FIT reminder calls resulted in a 34% return rate. Training providers and staff increased CRC knowledge and buy-in support by the entire practice and not just providers. Year two is on-going and results will be reported in July 2017.

Conclusions/Implications: Conducting multiple EBIs in an intensive time-frame is an efficacious method of adopting practice change in primary care health systems.