Assessing Levels and Correlates of Implementation of Evidence-Based Approaches for Colorectal Cancer Screening: A Cross-Sectional Study with Federally Qualified Health Centers

Details

• Alternative Title:
  Health Educ Behav
• Personal Author:
  Walker, Timothy J. ; Risendal, Betsy ; Kegler, Michelle C. ; Friedman, Daniela B. ; Weiner, Bryan J. ; Williams, Rebecca S. ; Tu, Shin Ping ; Fernandez, Maria E.
• Description:
  Multiple evidence-based approaches (EBAs) exist to improve colorectal cancer screening in health clinics. The success of these approaches is tied to effective implementation. Therefore, the purpose of this study was to assess the implementation of EBAs for colorectal cancer screening and clinic-level correlates of implementation in federally qualified health centers (FQHCs). We conducted descriptive and cross-sectional analyses using data collected from FQHC clinics across seven states ( n = 51). A clinic representative completed electronic surveys about clinic characteristics (e.g., size, patient characteristics, and medical record system characteristics) and the implementation of Community Guide recommended EBAs (e.g., client reminders, small media, and provider assessment and feedback). We used bivariate Spearman correlations to assess clinic-level correlates with implementation outcomes. Most clinics were planning to implement, in the early implementation stages, or inconsistently implementing EBAs. No EBA was fully implemented by more than nine (17.6%) clinics. Clinic size variables were inversely related to implementation levels of one-on-one education; medical record variables were directly related to implementation levels of client and provider reminders as well as provider assessment and feedback; and rapid and timely feedback from clinic leaders was directly associated with implementation levels of four out of six EBAs. Given the varying levels of implementation, clinics need to assess current use of implementation strategies and improve effective program delivery to increase colorectal cancer screening among their patients. In addition, clinics should also consider how their characteristics may support or serve as a barrier to implementation in their respective settings.
• Keywords:
  Cancer Prevention & Screening Colorectal Cancer Colorectal Neoplasms Community Health Centers Cross-Sectional Studies Early Detection Of Cancer Evidence-Based-Approaches Evidence-Based Practice Humans Implementation And Dissemination Implementation Science Poverty Primary Health Care Safety-net Providers Surveys And Questionnaires

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• Source:
  Health Educ Behav. 45(6):1008-1015
• Pubmed ID:
  29991294
• Pubmed Central ID:
  PMC6226355
• Document Type:
  Journal Article
• Funding:
  U48 DP001938/DP/NCCDPHP CDC HHSUnited States/ ; R01 CA124397/CA/NCI NIH HHSUnited States/ ; U48 DP001911/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP001936/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP001903/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP001944/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP001946/DP/NCCDPHP CDC HHSUnited States/ ; R25 CA116339/CA/NCI NIH HHSUnited States/ ; U48 DP001934/DP/NCCDPHP CDC HHSUnited States/ ; R21 CA136460/CA/NCI NIH HHSUnited States/ ; U48DP001944/ACL/ACL HHSUnited States/ ; U48 DP001924/DP/NCCDPHP CDC HHSUnited States/ ; R25 CA057712/CA/NCI NIH HHSUnited States/ ; T32 CA057712/CA/NCI NIH HHSUnited States/ ; U48 DP001949/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  45
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:928f9720b91323ba30089de55dd1b54926f5c568465050da384bacc832b349e6
• Download URL:
  https://stacks.cdc.gov/view/cdc/60602/cdc_60602_DS1.pdf
• File Type:
  [PDF - 326.78 KB ]