Colorectal Cancer Control Program Grantees’ Use of Evidence-Based Interventions

Abstract

Background Colorectal cancer (CRC) screening is recommended for adults aged 50–75 years, yet screening rates are low, especially among the uninsured. The CDC initiated the Colorectal Cancer Control Program (CRCCP) in 2009 with the goal of increasing CRC screening rates to 80% by 2014. A total of 29 grantees (states and tribal organizations) receive CRCCP funding to (1) screen uninsured adults and (2) promote CRC screening at the population level. Purpose CRCCP encourages grantees to use one or more of five evidence-based interventions (EBIs) recommended by the Guide to Community Preventive Services. The purpose of the study was to evaluate grantees’ EBI use. Methods A web-based survey was conducted in 2011 measuring grantees’ use of CRC screening EBIs and identifying their implementation partners. Data were analyzed in 2012. Results Twenty-eight grantees (97%) completed the survey. Most respondents (96%) used small media. Fewer used client reminders (75%); reduction of structural barriers (50%); provider reminders (32%); or provider assessment and feedback (50%). Provider-oriented EBIs were rated as harder to implement than client-oriented EBIs. Grantees partnered with several types of organizations to implement EBIs, many with county- or state-wide reach. Conclusions Almost all grantees implement EBIs to promote CRC screening, but the EBIs that may have the greatest impact with CRC screening are implemented by fewer grantees in the first 2 years of the CRCCP.

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

“…A previous study assessing the use of Community Guide-recommended EBAs by Colorectal Cancer Control Program Grantees indicated that clinics implemented 3.15 EBAs on average (Hannon et al, 2013). In addition, small media and client reminders were the most commonly used EBAs.…”

“…was collected from respondents since they were answering on behalf of clinics. Implementation levels of each CRCS EBA were measured using six different questions (Table 2) (Hannon et al, 2013). The survey also included 12 questions related to clinic characteristics used in analyses (Table 2).…”

Building Capacity for Evidence-Based Public Health: Reconciling the Pulls of Practice and the Push of Research

“…Investigating these gaps leads to several key findings: 1) practitioners underuse EBIs (91, 92); 2) passive approaches for disseminating EBIs are largely ineffective, because dissemination does not happen spontaneously (15, 121); 3) stakeholder involvement in the research or evaluation process (so-called practice-based evidence that responds to the “pull” of practitioners) is likely to enhance dissemination (80, 81, 85, 88, 97, 99, 180); 4) theory and planning frameworks are useful to guide the uptake of EBIs (172); and 5) capacity-building approaches in health-related settings (public health, medical care, policy) should be time-efficient, consistent with organizational climate, culture and resources, and aligned with the needs and skills of staff members (20, 119). …”

Use of Evidence-Based Interventions to Address Disparities in Colorectal Cancer Screening

“…A systematic review of these interventions found their use resulted in median increases of 11%-15% in completed CRC screenings (14). On average, CRCCP grantees have implemented three EBIs, with client-oriented interventions (i.e., client reminders and small media), which grantees report as easier to implement, being the most commonly used (15). CRCCP grantees were found to be more likely to implement EBIs than state health departments without CDC funding, suggesting that with sufficient programmatic support, these interventions can be widely adopted in various settings and, if implemented, can increase CRC screening (16).…”