Abstract
Appalachian regions of Kentucky and Ohio are hotspots for colorectal cancer (CRC) mortality in the USA. Screening reduces CRC incidence and mortality; however, screening uptake is needed, especially in these underserved geographic areas. Implementation science offers strategies to address this challenge. The aim of the current study was to conduct multi-site, transdisciplinary research to evaluate and improve CRC screening processes using implementation science strategies. The study consists of two phases (Planning and Implementation). In the Planning Phase, a multilevel assessment of 12 health centers (HC) (one HC from each of the 12 Appalachian counties) was conducted by interviewing key informants, creating community profiles, identifying HC and community champions, and performing HC data inventories. Two designated pilot HCs chose CRC evidence-based interventions to adapt and implement at each level (i.e., patient, provider, HC, and community) with evaluation relative to two matched control HCs. During the Implementation Phase, study staff will repeat the rollout process in HC and community settings in a randomized, staggered fashion in the remaining eight counties/HCs. Evaluation will include analyses of electronic health record data and provider and county surveys. Rural HCs have been reluctant to participate in research because of concerns about capacity; however, this project should demonstrate that research does not need to be burdensome and can adapt to local needs and HC abilities. If effective, this approach could be disseminated to HC and community partners throughout Appalachia to encourage the uptake of effective interventions to reduce the burden of CRC.
Document Type
Article
Publication Date
5-2023
Digital Object Identifier (DOI)
https://doi.org/10.1093/tbm/ibad017
Funding Information
This study is funded by the National Cancer Institute (4UH3CA233282-02) and supported in part by NCI Cancer Center Support Grants (P30CA177558) and (P30CA016058). Dr. Biederman is supported by NCI T32CA229114.
Repository Citation
Paskett, Electra D.; Kruse-Diehr, Aaron J.; Oliveri, Jill M.; Vanderpool, Robin C.; Gray, Darrell M. II; Pennell, Michael L.; Huang, Bin; Young, Gregory S.; Fickle, Darla; Cromo, Mark; Katz, Mira L.; Reiter, Paul L.; Rogers, Melinda; Gross, David A.; Fairchild, Vickie; Xu, Wendy; Carman, Angela; Walunis, Jean M.; McAlearney, Ann Scheck; Huerta, Timothy R.; Rahurkar, Saurabh; Biederman, Erika; and Dignan, Mark B., "Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science (ACCSIS) in Appalachia: protocol for a group randomized, delayed intervention trial" (2023). UK CARES Faculty Publications. 63.
https://uknowledge.uky.edu/ukcares_facpub/63
Included in
Applied Behavior Analysis Commons, Behavioral Neurobiology Commons, Medicine and Health Sciences Commons
Notes/Citation Information
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