Grant Number:	5UH3CA244298-05 Interpret this number
Primary Investigator:	Davis, Melinda
Organization:	Oregon Health & Science University
Project Title:	Screening More Patients for Crc Through Adapting and Refining Targeted Evidence-Based Interventions in Rural Settings (Smarter Crc)
Fiscal Year:	2023

PROJECT SUMMARY/ABSTRACT: This two-phase project is designed to achieve the Cancer Moonshot objectives by reducing the burden of CRC on the US population. Specifically, we aim to improve CRC screening rates, follow-up colonoscopy, and referral to care in rural Medicaid patients by implementing a direct mail fecal testing program with targeted outreach and patient navigation for follow-up colonoscopy. We leverage partnerships with the Oregon Rural Practice-based Research Network (ORPRN), Kaiser Northwest Center for Health Research, and Medicaid Health Plans and deliver training and implementation support to participating rural primary care clinics using practice facilitation. In total, we anticipate working with 30 organizations to facilitate implementation with 130 primary care clinics (reaching 17,000+ rural Medicaid patients). In Phase I (Year 01), we will conduct a milestone driven pilot to build the necessary infrastructure for a large-scale implementation-effectiveness trial, including adapting the clinic-health plan-vendor supported direct mail program for rural Medicaid patients that have not established care and/or never been screened; conducting a pilot study testing the feasibility and acceptability of patient navigation to support follow-up colonoscopy following an abnormal fecal test; engaging Medicaid Health Plans and recruiting 30 primary care clinics located in rural and frontier counties in Oregon; and developing the training and support materials needed to implement a large-scale trial in these settings. In Phase II (Years 02-05), we will conduct an implementation-effectiveness study using a quasi- experimental stepped wedge design in 30 rural primary care clinics using program training and practice facilitation to support implementation. As in the pilot, the intervention combines: (1) a clinic-health plan- vendor supported direct-mail fecal testing program with targeted outreach for patients who have never been screened or who have yet to establish care and (2) patient navigation for those who are referred for colonoscopy as either the primary screening or for follow-up from an abnormal fecal test. We will evaluate effectiveness, implementation, and maintenance of the intervention through quantitative and qualitative measures. Results from the implementation study will inform scale-up of the program through partnerships with 20 regional and national organizations that serve rural/frontier primary care clinics using webinars, train-the-trainer workshops and collaborative learning activities using the ECHO (Extension for Community Healthcare Outcomes) model.




Adaptations to a patient navigation program for follow-up colonoscopy in rural primary care practices.
Authors: Thompson J.H. , Rivelli J.S. , Schneider J.L. , Kenzie E.S. , Myers E. , Coury J. , Davis M. , Gautom P. , Coronado G.D. .
Source: Journal Of Evaluation In Clinical Practice, 2024-06-27 00:00:00.0; , .
EPub date: 2024-06-27 00:00:00.0.
PMID: 38935862
Related Citations

Methods for scaling up an outreach intervention to increase colorectal cancer screening rates in rural areas.
Authors: Coury J. , Coronado G. , Currier J.J. , Kenzie E.S. , Petrik A.F. , Badicke B. , Myers E. , Davis M.M. .
Source: Implementation Science Communications, 2024-01-08 00:00:00.0; 5(1), p. 6.
EPub date: 2024-01-08 00:00:00.0.
PMID: 38191536
Related Citations

Engaging with Rural Communities for Colorectal Cancer Screening Outreach Using Modified Boot Camp Translation.
Authors: Coury J. , Coronado G.D. , Myers E. , Patzel M. , Thompson J. , Whidden-Rivera C. , Davis M.M. .
Source: Progress In Community Health Partnerships : Research, Education, And Action, 2024; 18(1), p. 47-59.
PMID: 38661826
Related Citations

Effort Required and Lessons Learned From Recruiting Health Plans and Rural Primary Care Practices for a Cancer Screening Outreach Study.
Authors: Badicke B. , Coury J. , Myers E. , Petrik A.F. , Hiebert Larson J. , Bhadra S. , Coronado G.D. , Davis M.M. .
Source: Journal Of Primary Care & Community Health, 2024 Jan-Dec; 15, p. 21501319241259915.
PMID: 38864248
Related Citations

Provision of colonoscopy in rural settings: A qualitative assessment of provider context, barriers, facilitators, and capacity.
Authors: Ramalingam N. , Coury J. , Barnes C. , Kenzie E.S. , Petrik A.F. , Mummadi R.R. , Coronado G. , Davis M.M. .
Source: The Journal Of Rural Health : Official Journal Of The American Rural Health Association And The National Rural Health Care Association, 2023-09-07 00:00:00.0; , .
EPub date: 2023-09-07 00:00:00.0.
PMID: 37676061
Related Citations

Characteristics of patient navigation programs in the Cancer Moonshot ACCSIS colorectal cancer screening initiative.
Authors: Coronado G.D. , Ferrari R.M. , Barnes A. , Castañeda S.F. , Cromo M. , Davis M.M. , Doescher M.P. , English K. , Hatcher J. , Kim K.E. , et al. .
Source: Journal Of The National Cancer Institute, 2023-06-08 00:00:00.0; 115(6), p. 680-694.
PMID: 36810931
Related Citations

Data Challenges in Identifying Patients Due for Colorectal Cancer Screening in Rural Clinics.
Authors: Petrik A.F. , Coury J. , Larson J.H. , Badicke B. , Coronado G.D. , Davis M.M. .
Source: Journal Of The American Board Of Family Medicine : Jabfm, 2023-02-08 00:00:00.0; 36(1), p. 118-129.
PMID: 36759133
Related Citations

Impact of the COVID-19 vaccination mandate on the primary care workforce and differences between rural and urban settings to inform future policy decision-making.
Authors: Hatch B.A. , Kenzie E. , Ramalingam N. , Sullivan E. , Barnes C. , Elder N. , Davis M.M. .
Source: Plos One, 2023; 18(6), p. e0287553.
EPub date: 2023-06-27 00:00:00.0.
PMID: 37368922
Related Citations

System dynamics modeling for cancer prevention and control: A systematic review.
Authors: Kenzie E.S. , Seater M. , Wakeland W. , Coronado G.D. , Davis M.M. .
Source: Plos One, 2023; 18(12), p. e0294912.
EPub date: 2023-12-01 00:00:00.0.
PMID: 38039316
Related Citations

Primary Care Research Is Hard to Do During COVID-19: Challenges and Solutions.
Authors: Holtrop J.S. , Davis M.M. .
Source: Annals Of Family Medicine, 2022 Nov-Dec; 20(6), p. 568-572.
PMID: 36443077
Related Citations

Mailed fecal testing and patient navigation versus usual care to improve rates of colorectal cancer screening and follow-up colonoscopy in rural Medicaid enrollees: a cluster-randomized controlled trial.
Authors: Coronado G.D. , Leo M.C. , Ramsey K. , Coury J. , Petrik A.F. , Patzel M. , Kenzie E.S. , Thompson J.H. , Brodt E. , Mummadi R. , et al. .
Source: Implementation Science Communications, 2022-04-13 00:00:00.0; 3(1), p. 42.
EPub date: 2022-04-13 00:00:00.0.
PMID: 35418107
Related Citations

Mailed fecal immunochemical test outreach for colorectal cancer screening: Summary of a Centers for Disease Control and Prevention-sponsored summit.
Authors: Gupta S. , Coronado G.D. , Argenbright K. , Brenner A.T. , Castañeda S.F. , Dominitz J.A. , Green B. , Issaka R.B. , Levin T.R. , Reuland D.S. , et al. .
Source: Ca: A Cancer Journal For Clinicians, 2020-06-25 00:00:00.0; , .
EPub date: 2020-06-25 00:00:00.0.
PMID: 32583884
Related Citations

Who Is Reached With Clinic In-Reach and Outreach Strategies to Promote Colorectal Cancer Screening?
Authors: Coronado G.D. .
Source: American Journal Of Public Health, 2020 04; 110(4), p. 437-439.
PMID: 32159997
Related Citations