Abstract
Background Black Kentuckians experience more deleterious colorectal cancer (CRC) outcomes than their White counterparts, a disparity that could be reduced by increased screening in Black communities. Previous research has shown that Black Kentuckians may not be equitably informed of different CRC screening options by health care providers, making community‑based screening a potentially effective option among this disparate population. We used the Consolidated Framework for Implementation Research (CFIR) to identify church leaders’ perspectives of con‑ textual factors that might influence community‑based screening and explore the feasibility of using church‑based screening outreach.
Methods Six participants were selected, based on leadership roles and interest in CRC screening, from five established Louisville‑area church partners that had previously participated in community health initiatives. Data were collected, both virtually and in‑person, in Summer 2021 using semi‑structured interview guides developed with guidance from the CFIR Guide that focused on domains most relevant to community‑based interventions. Data were transcribed verbatim, coded by two independent researchers, and member checked for accuracy.
Results Data were aligned primarily with six CFIR constructs: key stakeholders, champions, opinion leaders, ten‑ sion for change, compatibility, and culture. Participants noted a strong tension for change in their community due to perceptions of inadequacy with clinical approaches to CRC screening. Additionally, they stressed the importance of identifying individuals both within the church who could champion CRC screening and help implement pro‑ gram activities, as well as those outside the church who could collaborate with other local organizations to increase participant reach. Finally, participants agreed that faith‑based CRC screening aligned with church culture and would also likely be compatible with overall community values.
Conclusions Overall, our church partners strongly endorsed the need for, and importance of, community‑based CRC screening. Given a history of successful implementation of health promotion programs within our partner churches, it is highly likely that a CRC screening intervention would also be effective. Findings from this study will be used to iden‑ tify implementation strategies that might positively impact a future faith‑based CRC screening intervention, as well as CFIR constructs that are most positively associated with CRC screening completion.
Document Type
Article
Publication Date
2024
Digital Object Identifier (DOI)
https://doi.org/10.1186/s43058‑024‑00621‑9
Funding Information
This publication was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR001998 and by the National Cancer Institute through the Cancer Center Support Grant P30CA177558. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Repository Citation
Kruse-Diehr, Aaron J.; Cegelka, Derek; Combs, Carlee; Wood, Rose; Holtsclaw, Elizabeth; Stapleton, Jerod L.; and Williams, Lovoria B., "Using the consolidated framework for implementation research to identify church leaders’ perspectives on contextual determinants of community‑based colorectal cancer screening for Black Kentuckians" (2024). UK CARES Faculty Publications. 9.
https://uknowledge.uky.edu/ukcares_facpub/9
Notes/Citation Information
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