Evidence-Based Colorectal Cancer Screening Promotion

1. Evidence-Based Colorectal Cancer Screening Promotion Peggy Hannon, PhD, MPH September 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.

2. Colorectal Cancer Control Program (CRCCP) Goal: Increase CRC screening to 80% by 2014 Provide screening to un/underinsured Promote screening population-wide

3. CRCCP Grantees

4. Community Guide Strategies 5 strategies to promote CRC screening: Client-oriented Small media Client reminders Reducing structural barriers Provider-oriented Provider reminders Provider assessment and feedback

5. Opportunity for CPCRN Mission: Accelerate evidence-based intervention (EBI) adoption Shift in CDC’s approach from NBCCEDP to CRCCP Grantees urged to use Guide-recommended EBIs

6. CRCCP Workgroup Goals Study EBI adoption, implementation, maintenance Implement Annual Grantee Survey 2011-2014 Develop additional studies

7. Annual Grantee Survey 2011: 28 grantees participated (96%) 2012: 29 grantees participated (100%) 2012: Unfunded states/tribes: 24 participated (69%)

8. 2011: Most Grantees Use >1 EBI

9. 2012: EBI Use Increased

10. 2012: Grantees Use More EBIs than Unfunded Sites

11. Patient Navigation Navigators 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

12. 2012: Grantees Use Other Strategies *Added as a Guide-recommended strategy in 2012

13. 2012: Grantees Want Training for Provider-Oriented EBIs

14. 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

15. Other Survey Topics Program management CRCCP integration with other programs CRC screening provision Data from FQHCs and IHS clinics CRC screening policies and strategies

16. Where Are We Now? 2013 Annual Survey in the field (Grantees only) Preparation for 2014 Annual Survey (Grantees & unfunded sites) In-depth interview study

17. In-depth Interviews Explore: Policy and systems-level EBIs Partnerships Transition from providing to promoting screening 13 of 14 interviews completed

18. Collaboration with CRCCP Program Evaluation Team Develop 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

19. Papers and Presentations Papers Grantees’ 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

20. Collaborators CPCRN Sites Emory Harvard UCLA U Colorado UNC U S. Carolina U Texas Washington U-St. Louis U Washington CDC Amy DeGroff Lindsay Gressard Ketra Rice Vicki Benard CRCCP Evaluation Team NCI Russ Glasgow Mike Sanchez Cynthia Vinson

21. CRCCP Workgroup Co-Chairs Peggy Hannon University of Washington peggyh@uw.edu Cam Escoffery Emory University cescoff@emory.edu Annette Maxwell University of California at Los Angeles amaxwell@ucla.edu