Shin-Ping Tu, MD, MPH; Maria Fernandez, PhD, Vicki Young, PhD

1. The CPCRN FQHC Workgroup Survey Results: Implementation of Evidence-Based Approaches (EBAs) for Promoting CRC Screening Shin-Ping Tu, MD, MPH; Maria Fernandez, PhD, Vicki Young, PhD on behalf of the CPCRN FQHC Workgroup Investigators Denver, CO Oct 3rd, 2013 This presentation was supported by Cooperative Agreement Numbers U48-DP001909, U48-DP001946, U48-DP001924, U48-DP001934, U48-DP001938(03), U48-DP001944, U48-DP001936, U48-DP001949-02, U48–DP001911, & U48-DP001903 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. EBAs for Promoting CRC Screening in the FQHC Survey CHC Main Survey: • Provider Reminders • Patient Reminders • One-on-one Education • Provider Assessment & Feedback Clinic Characteristics Survey: • One-on-one Education • Reducing Structural Barriers • Patient Reminders • Provider Assessment & Feedback • Patient Navigators • Provider Reminders

3. Assessment of EBA implementation

4. Levels of Implementation of EBAs for Promoting CRC Screening—Main Survey Missing Frequencies: 20

5. Levels of Implementation of EBAs for Promoting CRC Screening—Clinic Survey

6. Organizational Factors Assessed in CHC Main Survey General Factors • Practice Adaptive Reserve • Inner Setting: • Structural Characteristics—Resources • Culture- innovation, flexibility, & reflexivity, • Culture- stress & effort • Network & Communication (using PAR items) • Leadership (using PAR items) • Outer Setting: • Patient needs & resources (Patient-centeredness) • Process: • Executing • Reflecting & Evaluating • Engagement • Individual Characteristics: • Knowledge & Beliefs—Openness EBA-specific Factors • EBA Characteristics: • Relative advantage • Complexity • Inner Setting: • Compatibility • Implementation climate • Goals and feedback • Learning climate(using PAR items) • Structural characteristics—resources • Process: • Engaging Champions • Individual Characteristics • Knowledge and Beliefs—Appeal

7. Organizational Factors Assessed in Clinic Characteristics Survey • EBA-Specific Factors • Tension for change • Organizational Incentives and Rewards • Goals and Feedback • Outer Setting: External policies and incentives

8. Preliminary Results from Multi-level Analysis (Main Survey)

9. Provider Reminders: Predictors of Implementation • *Associated with higher levels of provider reminder implementation • Adjusted for education, which is significantly correlated to the outcome • Number of respondents =296

10. Provider Reminders: EBI-Specific Predictors of Implementation • *Associated with higher levels of provider reminder implementation • Adjusted for education • Number of respondents =296

11. Patient Reminder: Predictors of Implementation • *Aassociated with higher levels of provider reminder implementation • Adjusted for education • Number of respondents =296

12. One-on-One Education: Predictors of Implementation • *Odds ratio over 1 means associated with higher levels of provider reminder implementation • Adjusted for education • Number of respondents =296

13. Provider Assessment & Feedback: General Predictors • *Odds ratio over 1 means associated with higher levels of provider reminder implementation • Adjusted for education • Number of respondents =296

14. Significance • This study is among the first to examine determinants from the Consolidated Framework for Implementation Research (CFIR) on implementation of evidence based cancer control interventions.