1. Cancer Screening Programs Workgroup
Active members:
CDC
NCI
OHSU UW
Expert Affiliates – Emory and UCLA

2. Project Objectives and Aims

3. Aim 1 – CRCCP-1 impact on EBI use
Analyze CRCCP-1 EBI data
In process
Share survey instrument with workgroup, identify potential manuscripts
Instrument shared

4. EBI use (mostly) increased 0ver time

5. But implementation did not get easier…
Ease of implementation, 1=very difficult, 5=very easy

6. Aim 2: CRCCP-2 CRCCP-2 funds 31 Grantees 2015-2020
All Grantees must partner with 1+ healthcare systems to implement 2+ EBIs
Client reminders
Reducing structural barriers
Provider reminders
Provider assessment and feedback
Each healthcare system is providing clinic-level data, baseline and annually

7. WA: Health System Partners – Year 1
HealthPoint
Sea Mar
3rd largest FQHC in WA 80,000 patients/year 13 clinics in King County 13,908 patients eligible for CRC Goal – increase screening rate 51% to 60%
Largest FQHC in WA More than 200,000 patients/year 28 medical clinics in WA Attempt to reach 15,000 patients Goal – increase screening rate 28% to 40%

8. WA - Planned Interventions
HealthPoint
SeaMar
9 Clinics will participate Mailed FIT kits Patient reminders Provider assessment and feedback Pilot FluFIT, 2-3 sites Provider education Group patient education
All clinics will participate Mailed FIT kits Patient reminders Provider assessment and feedback Provider education Patient digital stories

9. CRCCP-2 program reach: totals*
Health systems: 92
Clinics: 296
Patients, ages 50-75: 492,234
Providers: 2,153
* Totals reflect data from 24 of 30 grantees and do not include data from clinic worksheets that had missing IDs.

10. Program reach* Mean Median Range Per Grantee Health Systems 4 3 1 - 12
Clinics 12 8
1 - 40
Per Clinic
Patients, ages 50-75
1,674
863
27 – 19,744
Providers (n= 286)
* Data from 24 of 30 grantees.

11. CLINIC TYPE* (N= 296)
78% of clinics are Patient Centered Medical Home-recognized
* Data from 24 of 30 grantees.

12. Primary test type used in clinics* (N= 296)
* Data from 24 of 30 grantees.

13. CRC SCREENING RATES AT BASELINE* (N=286)
Chart Review (n= 35)
EHR (n= 264)*
Mean
37%
33%
Median
32%
Range
2% - 76%
0.3% - 85%
*Of the clinics reporting an EHR-calculated screening rate, 73% somewhat or very confident in the accuracy of the screening rate; 17% reported not confident, and 10% did not report a confidence level.

14. Clinics with EBIs in place at baseline
*Data from 24 of 30 grantees.

15. Grantee survey content
Respondent characteristics
Program management
Implementation activities
Non-health system partners
Data use
Training and TA needs
Component 2 grantees – CRC screening delivery 15

16. Aim 3: NBCCEDP and EBIs NBCCEDP starting to do similar Grantee surveys
Data collected 2013, 2015, planned 2016
Advantage of CRCCP and program integration?

17. Grantee survey content
Respondent information
Program activities – EBIs, PN, CHWs
Clinical service delivery
Provider network
Non-screening partnerships
Data use
Training and TA
Program management 17

18. Work in Progress & Next Steps

19. Manuscripts Papers in progress for CRCCP-1
Identifying potential manuscripts for CRCCP-2
Descriptive paper with clinic baseline data describing reach of CRCCP (clinics and patients) and presence of EBIs
Considering data analysis/manuscripts for NBCCEDP
Presence of CRCCP, integration of programs within Grantee

20. Contribution to D & I Science

21. D & I questions Ease of implementation – what’s happening?
Program integration – help, hinder, no effect on EBI implementation?
Public health/clinical partnerships and EBI implementation  impact on screening rates

22. Contribution to Cancer Prevention and Control

23. Contributions Partnership with CDC, nation-wide reach
Important transitions
Only providing screening for those who cannot afford to pay  combined with population-level efforts
ACA and different implementation in states  eligible population, identification, and reach

24. CPCRN opportunities Other workgroups interested in FQHCs FQHC Tobacco
Partner with CDC on sub-studies of Grantees
Case studies of program implementation
Mixed methods studies of promising practices
Be mindful: Grantee and Partner burden

25. Thank you! Discussion