BACKGROUND RESULTS METHODS Mailed Fecal Immunochemical Test (FIT) Kits to increase screening uptake in the University of Pennsylvania’s Community Service Area Ndidi Enwereji Chair: Dr. Russell McIntire Preceptor: Rebecca Pepe BACKGROUND RESULTS DISCUSSION & LIMITATIONS Response rates within the CSA were higher compared to response rates of patients residing outside the CSA (16.6% vs. 12.4%, respectively) The bivariate analysis showed positive correlation between race and CT-level median income as the main predictors of timely return of FIT kits within 2 months of patients residing in the Philadelphia-Camden-Wilmington Statistical Area in 2016 The odds of returning FIT kits within 2 months were 48.6% lower for African-American patients when compared to Whites Asians were 66.2% less likely to return their FIT kit within two months when compared to Whites Patients of Other/Unknown races also had lower response rates (52.4% less likely to return their FIT kit) when compared to Whites Patients that lived in census tracts with household median incomes earning less than $30,000 and $30,000-$45,000 were 62.8% and 62.1% less likely to return FIT kits within two months, respectively, when compared to patients residing in census tracts with median household incomes earning $100,000 or more Proximity analysis of patients residing within the CSA: Patients residing within 2.09 miles of HUP had higher response rates compared to patients residing 4.19 miles from HUP Response rate of patients residing within 2.09 miles of HUP : 59% Response rate of patients residing within 4.19 miles of HUP: 41% Limitations: Use of individual and area-level variables Use of EMR and self-reported data Need for more rigorous EMR audits Influence of financial incentives on response rate not analyzed Colorectal cancer (CRC) is the 2nd leading cause of cancer death African Americans are particularly affected Socioeconomic status (SES), gender and age are important factors that influence screening 1 in 3 adults do not comply with CRC screening Penn’s Community Service Area (CSA): A majority of families live in poverty (53% ) 49% (25 and older) have high school-level education 1 in 4 adults 50 years and older in the service area are non-compliant with CRC Fecal Immunochemical Test (FIT): Noninvasive, fecal occult blood test used to detect specific antibody for human hemoglobin A commonly used modality for CRC screening in average-risk patients Mailed to patients fitting Colorectal Cancer Screening Outreach (CRCSO) program criteria listed below (Figure 1) Research Questions: Does colonoscopy screening by mailed FIT test completion within 2 months vary significantly for patients of the CRCSO pilot program residing within vs outside the CSA? How does area-level SES correlate with FIT colonoscopy screening adherence within 2 months for patients mailed FIT kits in the pilot program? Table 1. Binary Logistic Regression of Race and Return of FIT Kit within 2 Months Table 2. Binary Logistic Regression of Median Income and Return of FIT Kit within 2 Months METHODS Population: CRCSO pilot program (eligibility criteria below) Data source: PennChart and American Census Survey Outcome: Completion and return of FIT kit within 2mths. Bivariate analysis using chi-squared statistical test to determine statistically significant variable associated with the return of FIT kits within 2 months Simple logistic regression model was used to determine the probability of patients returning their FIT kits within 2 months Proximity analysis: Geocoded patient address to census tract (CT) Buffers Table 3. Binary Logistic Regression of High School Graduation Rate and Return of FIT Kit within 2 Months CORE COMPETENCIES Analytic/Assessment Skills Communication Skills Cultural Competency Skills Community Dimensions of Practice Skills (advancing community involvement) Public Health Sciences Skills (critiquing and developing research) Leadership and Systems Thinking Skills Figure 1. Flowchart of program processes & Eligibility Criteria Eligibility Criteria: 50-75 years old 2 primary family care (PFC) visits in 2 years Philadelphia-Camden-Wilmington Metropolitan Statistical Area Average risk for CRC and eligible to receive colonoscopy   Figure 2. Proximity Analysis ACKNOWLEDGEMENTS The author would like to thank Dr. McIntire, Dr. McAna and Dr. LaNoue for providing their guidance and expertise towards the completion of this project, as well as Dr. Chyke Doubeni and Rebecca Pepe of Penn Presbyterian Medical Center for providing the data used in this study.