PS1-55: Strategies and Opportunities to STOP Colon Cancer in Priority Populations: Pragmatic Study Design and Methods

Abstract

Background/AimsColorectal cancer (CRC) is the second leading cause of cancer death in the United States. One key factor thought to explain the relative high mortality is low utilization of screening services for CRC. Data from the National Health Interview Survey show that, in 2010, 41% of adults aged 50–75—nearly 35 million people—were not up-to-date with CRC screening. Almost 30% of eligible adults have never had any type of CRC screening. Screening rates are alarmingly low among certain population subgroups, including those with minimal education, low income, or having no health insurance. The subgroups least likely to be up-to-date with screening are those who receive preventive care services, including CRC screening, at Federally Qualified Health Centers (FQHCs). Strategies and Opportunities to STOP Colorectal Cancer in Priority Populations (STOP CRC) is a collaborative partnership between health research institutions and FQHCs to raise rates of CRC screening in FQHCs. STOP CRC uses a pragmatic design to evaluate health systems-based approaches to CRC screening among age-eligible patients who receive care at FQHCs.MethodsSTOP CRC has two phases. In Phase I (Year 01), we will pilot-test an evidence-based approach to improve participation in CRC screening in two FQHCs. This phase will include an assessment of the intervention’s feasibility, effectiveness, and cost. In Phase II (Years 02–05), we will conduct a comparative effectiveness pragmatic clinical trial, using a mixed-methods approach to evaluate the adoption, implementation, and maintenance of our CRC screening program. Throughout the project, we will involve a diverse planning advisory group of FQHC clinicians and patients, community representatives, state policy makers, and researchers, using principles of Community-Based Participatory Research.ConclusionsSTOP CRC is a large-scale approach to raising rates of colorectal cancers screening in FQHCs. STOP CRC is expected to expand meaningful use of electronic health information; synergistically meet national goals to improve cancer screening rates, address health disparities, reduce health care costs; and act as a catalyst for future systems-based approaches to improve care delivery in FQHCs and other health systems.