Increasing Colorectal Cancer Screening at Community-Based Primary Care Clinics in San Francisco

Marx, Rani; Tse, Winnie M.; Golden, Lisa; Johnson, Elizabeth C.

doi:10.1097/phh.0000000000000275

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…This study has demonstrated that EMR data can be used to determine patients’ preventive care screening statuses. This automated function could be developed for other EMRs to generate monthly preventive care reports for providers [ 29 ]. These reports could then be used for targeted preventive care delivery, prioritising in-person visits for those most overdue or needing tests that require in-person assessments.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, point-of-care tools could support opportunistic preventive care delivery during visits for other reasons. The literature supports that digital solutions like EMR reminders [ 30 ] combined with active panel management [ 29 , 30 ] can improve screening rates. However, in order to leverage EMR data to improve preventive care rates, system capacity must be improved as laboratories have only recently restored some capacity for screening test [ 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study

Laing

Johnston

2021

BMC Health Serv Res

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Background COVID-19 has caused significant healthcare service disruptions. Surgical backlogs have been estimated but not for other healthcare services. This study aims to estimate the backlog of preventive care services caused by COVID-19. Methods This observational study assessed preventive care screening rates at three primary care clinics in Ottawa, Ontario from March to November 2020 using data from 22,685 electronic medical records. The change in cervical cancer, colorectal cancer, and type 2 diabetes screening rates were crudely estimated using 2016 census data, estimating the volume of key services delayed by COVID-19 across Ontario and Canada. Results The mean percentage of patients appropriately screened for cervical cancer decreased by 7.5% (− 0.3% to − 14.7%; 95% CI), colorectal cancer decreased by 8.1% (− 0.3% to − 15.8%; 95% CI), and type 2 diabetes decreased by 4.5% (− 0.2% to − 8.7%; 95% CI). Crude estimates imply 288,000 cervical cancer (11,000 to 565,000; 95% CI), 326,000 colorectal cancer (13,000 to 638,000; 95% CI), and 274,000 type 2 diabetes screenings (13,000 to 535,000; 95% CI) may be overdue in Ontario. Nationally the deficits may be tripled these numbers. Re-opening measures have not reversed these trends. Interpretation COVID-19 decreased the delivery of preventive care services, which may cause delayed diagnoses, increased mortality, and increased health care costs. Virtual care and reopening measures have not restored the provision of preventive care services. Electronic medical record data could be leveraged to improve screening via panel management. Additional, system-wide primary care and laboratory capacity will be needed to restore pre-COVID-19 screening rates.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study

Laing

Johnston

2021

BMC Health Serv Res

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“…The majority of employees at UAH are White (78%) with African Americans comprising 13%, Asian Americans 7%, and Hispanics and Native Americans 1% each (UAH Human Resources Department, personal communication, March 10, 2015). According to the cancer screening literature, interventions that increase screening prevalence include mailed letters, e-mail notifications, availability of free test kits, and postscreening phone calls and letters (Coronado et al, 2014; Gupta et al, 2013; Marx, Tse, Golden, & Johnson, 2015). The UAH Faculty and Staff Clinic reached out to employees via presentations, posters, campus e-mails, and letters (Figure 2).…”

Section: Discussionmentioning

confidence: 99%

Screening for Colorectal Cancer at the Worksite

O’Keefe

Sullivan

McPhail

et al. 2017

Workplace Health Saf

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Colorectal cancer (CRC) is the second leading cause of cancer-related deaths among men and women in the United States. To increase statewide CRC screening rates, the Alabama Department of Public Health (through a Centers for Disease Control and Prevention [CDC] Colorectal Cancer Control Program grant) partnered with The University of Alabama in Huntsville (UAH) and The University of South Alabama (USA) to provide free CRC screening opportunities to eligible University employees and dependents. Resources were invested at both universities to ensure participant education, tracking, and monitoring. In total, 86 fecal immunochemical tests (FITs) were distributed at the UAH campus and 62 were returned for testing; 146 FITs were distributed on the USA campus with 111 returned. Fecal immunochemical test return rates were over 70% at each site. Most notably, 21 positive FITs were identified among UAH participants and 25 at USA. Findings from both efforts suggest that employer-based screening initiatives are a systematic and replicable means of improving CRC screening.

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“…Twenty-two studies from the US (n = 18), Canada (n = 3) and Australia (n = 1) were multi-component non-randomized trials (Potter et al, 2011;Kaczorowski et al, 2013;Dorrington et al, 2015;Harris et al, 2015;Hills et al, 2015;Mader et al, 2016;Marx et al, 2016;Wu et al, 2016;Baxter et al, 2017;Green et al, 2017;Hountz et al, 2017;Weiner et al, 2017;Bakhai et al, 2018;Nguyen et al, 2020;Desai et al, 2021;Funes et al, 2021;Frissora et al, 2021;Hussain et al, 2021;Jones et al, 2022;Ruggeri et al, 2020;Walker-Smith and Baldwin, 2020;Willemse et al, 2022) (Table 3).…”

Section: Multi-componentnon-randomized Trialsmentioning

confidence: 99%

“…However, a supplementary population-level study by Green et al (2017) found a positive effect on bowel screening and cervical screening. Marx et al (2016) assessed the effect of a continuous QI project to increase bowel screening rates at five clinics, with components including audit and feedback, provider education and training, provider financial incentives, patient education, and patient reminders. A continuous positive effect was found in three of the five clinics.…”

Section: Qi Projectsmentioning

confidence: 99%

Primary care practice-based interventions and their effect on participation in population-based cancer screening programs: a systematic narrative review

Verbunt,

Newman,

Creagh

et al. 2024

Prim Health Care Res Dev

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Aim: To provide a systematic synthesis of primary care practice-based interventions and their effect on participation in population-based cancer screening programs. Background: Globally, population-based cancer screening programs (bowel, breast, and cervical) have sub-optimal participation rates. Primary healthcare workers (PHCWs) have an important role in facilitating a patient’s decision to screen; however, barriers exist to their engagement. It remains unclear how to best optimize the role of PHCWs to increase screening participation. Methods: A comprehensive search was conducted from January 2010 until November 2023 in the following databases: Medline (OVID), EMBASE, and CINAHL. Data extraction, quality assessment, and synthesis were conducted. Studies were separated by whether they assessed the effect of a single-component or multi-component intervention and study type. Findings: Forty-nine studies were identified, of which 36 originated from the USA. Fifteen studies were investigations of single-component interventions, and 34 studies were of multi-component interventions. Interventions with a positive effect on screening participation were predominantly multi-component, and most included combinations of audit and feedback, provider reminders, practice-facilitated assessment and improvement, and patient education across all screening programs. Regarding bowel screening, provision of screening kits at point-of-care was an effective strategy to increase participation. Taking a ‘whole-of-practice approach’ and identifying a ‘practice champion’ were found to be contextual factors of effective interventions. The findings suggest that complex interventions comprised of practitioner-focused and patient-focused components are required to increase cancer screening participation in primary care settings. This study provides novel understanding as to what components and contextual factors should be included in primary care practice-based interventions.

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Increasing Colorectal Cancer Screening at Community-Based Primary Care Clinics in San Francisco

Cited by 3 publications

References 16 publications

Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study

Estimated impact of COVID-19 on preventive care service delivery: an observational cohort study

Screening for Colorectal Cancer at the Worksite

Primary care practice-based interventions and their effect on participation in population-based cancer screening programs: a systematic narrative review

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