219114 Tailoring an evidence-based approach to colorectal cancer screening for Community Health Centers in North Carolina

Monday, November 8, 2010

Catherine Rohweder, DrPH , UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
Marti Wolf, RN, MPH , North Carolina Community Health Center Association, Morrisville, NC
Anna Schenck, MSPH, PhD , The Carolinas Center for Medical Excellence, Cary, NC
Venkat Prasad, MD, MBA/MHA , Rex Family Practice of Wakefield, Raleigh, NC
Sandra J. Diehl, MPH , UNC Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC
As a first step to increasing adherence to colorectal cancer screening guidelines in community health centers in NC, we have modified an existing curriculum produced by the National Colorectal Cancer Roundtable called “How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician's Evidence-Based Toolbox and Guide©”. Using a combination of expert opinion from guideline developers and focus groups with health center clinicians, we tailored the content for healthcare professionals who work primarily with indigent, uninsured patients. First, we updated the original toolbox with the PHS guidelines published in 2008 and collaborated with consultants to determine which components to include. Second, we held two focus groups with providers to review the draft toolbox and make recommendations. Third, we worked with an educational design company to incorporate the focus group findings and produce a cd for distribution. The final content consists of an introduction, three essentials for screening, and sample tools. The Three Essentials include: 1) An Office Policy that centers on risk assessment, algorithms for each type of screening, standardized counseling scripts, and patient materials; 2) A Provider Recommendation that advocates an opportunistic approach to screening and takes into account patient-level and local-level resources; 3) An Office Reminder System that utilizes standing orders, standardized documentation, and patient-level reminders. The Toolkit in the appendix contains laminated, easy-to-use tools that correspond to the recommendations in the Three Essentials. Our plans are to test a public health detailing approach by examining differences between randomly assigned intervention and control clinics.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related organizational policy, standards, or other guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. The audience will be able to identify five themes that emerged from provider focus groups on colorectal cancer screening 2. The audience will be able to identify five strategies for overcoming provider barriers to colorectal cancer screening in community health centers 3. The audience will be able to assess whether colorectal cancer screening for the uninsured can be increased by promoting fecal occult blood testing (FOBT)

Keywords: Cancer Screening, Community Health Centers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I direct a program designed to facilitate community-based research on cancer prevention, screening, and treatment.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.