Identifying optimal approaches to scale up colorectal cancer screening: an overview of the centers for disease control and prevention (CDC)’s learning laboratory
Tóm tắt
Use of recommended screening tests can reduce new colorectal cancers (CRC) and deaths, but screening uptake is suboptimal in the United States (U.S.). The Centers for Disease Control and Prevention (CDC) funded a second round of the Colorectal Cancer Control Program (CRCCP) in 2015 to increase screening rates among individuals aged 50–75 years. The 30 state, university, and tribal awardees supported by the CRCCP implement a range of multicomponent interventions targeting health systems that have low CRC screening uptake, including low-income and minority populations. CDC invited a select subset of 16 CRCCP awardees to form a learning laboratory with the goal of performing targeted evaluations to identify optimal approaches to scale-up interventions to increase uptake of CRC screening among vulnerable populations. This commentary provides an overview of the CRCCP learning laboratory, presents findings from the implementation of multicomponent interventions at four FQHCs participating in the learning laboratory, and summarizes key lessons learned on intervention implementation approaches. Lessons learned can support future program implementation to ensure scalability and sustainability of the interventions as well as guide future implementation science and evaluation studies conducted by the CRCCP learning laboratory.
Tài liệu tham khảo
United States Preventive Services Task Force (2016) Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA 315(23):2564–2575. https://doi.org/10.1001/jama.2016.5989
Centers for Disease Control and Prevention (CDC) (2017) Behavioral Risk Factor Surveillance System (BRFSS). http://www.cdc.gov/brfss/index.html. Accessed 18 Dec 2017
Health Resources & Services Administration (2016) National Health Center Data. https://bphc.hrsa.gov/uds/datacenter.aspx?q=t6b&year=2016&state=. Accessed 26 Jan 2018
Seeff LC, DeGroff A, Joseph DA, Royalty J, Tangka FK, Nadel MR, Plescia M (2013) Moving forward: using the experience of the CDCs’ Colorectal Cancer Screening Demonstration Program to guide future colorectal cancer programming efforts. Cancer 119(Suppl 15):2940–2946. https://doi.org/10.1002/cncr.28155
Community Preventive Services Task Force (2016) The guide to community preventive services. Centers for Disease Control and Prevention, Community Preventive Services Task Force, Atlanta. https://www.thecommunityguide.org/findings/cancer-screening-multicomponent-interventions-colorectal-cancer. Accessed 6 Oct 2017
DeGroff A, Sharma K, Satsangi A, Kenney K, Joseph D, Ross K, Leadbetter S, Helsel B, Kammerer B, Firth R, Rockwell T, Short W, Tangka F, Wong F, Richardson L (2018) Implementing evidence-based interventions in U.S. Healthcare Systems to increase colorectal cancer screening: year 1 results of the CDC Colorectal Cancer Control Program. Prev Chronic Dis (Paper Under Review)
Centers for Disease Control and Prevention (2016) Guidance for measuring colorectal cancer (CRC) screening rates in health system clinics. US Department of Health and Human Services, Atlanta. https://www.cdc.gov/cancer/crccp/pdf/Guidance_Measuring_CRC_Screening_Rates.pdf
Subramanian S, Tangka F, Hoover S, Royalty J, DeGroff A, Joseph D (2017) Costs of colorectal cancer screening provision in CDC’s Colorectal Cancer Control Program: comparisons of colonoscopy and FOBT/FIT based screening. Eval Program Plan 62:73–80. https://doi.org/10.1016/j.evalprogplan.2017.02.007
Tangka F, Subramanian S, Hoover S, Royalty J, Joseph K, DeGroff A, Joseph D, Chattopadhyay S (2017) Costs of promoting cancer screening: evidence from CDC’s Colorectal Cancer Control Program (CRCCP). Eval Program Plan 62:67–72. https://doi.org/10.1016/j.evalprogplan.2016.12.008
Health Resources and Services Administration (2018) UDS data comparison. https://bphc.hrsa.gov/uds/datacenter.aspx. Accessed on 7 Jan 2018
Subramanian S, Tangka F, Hoover S, Cole Beebe ME, DeGroff A, Royalty J et al (2013) Costs of planning and implementing federally funded colorectal cancer screening. Cancer 119(Suppl. 15):2855–2862
Trogdon JG, Ekwueme DU, Subramanian S, Crouse W (2014) Economies of scale in federally-funded, state-organized public health programs: results from the National Breast and Cervical Cancer Early Detection Programs. Health Care Manag Sci 17(4):321–330