Grant Number:	5U54CA163308-05 Interpret this number
Primary Investigator:	Skinner, Celette
Organization:	Ut Southwestern Medical Center
Project Title:	Parkand-UT Southwestern Prospr Center: Colon Cancer Screening in a Safety Net
Fiscal Year:	2015

The Parkland-UT Southwestern PROSPR Center represents a fully coordinated, trans-disciplinary partnership of the Parkland Health System, UT Southwestern Medical Center, Simmons Cancer Center, and UT School of Public Health. Our goal is to optimize colon cancer screening through personalized regimens in our integrated safety-net clinical provider network serving a large and diverse population of under- and uninsured patients in Dallas. Three interlocking research projects will assess clinic, system, and organizational factors associated with over-, under- and guideline-based screening among this vulnerable population, and will compare benefits, harms, and costs of strategies for facilitating optimized screening regimens. Project 1 employs an "in-reach" strategy by implementing innovative, algorithmically driven tools in primary-care and colonoscopy clinics to collect information including patients' familial risk factors and colonoscopy findings to: identify personalized guideline-based screening regimens; characterize under- and over-screening. Project 2, a comparative effectiveness trial, compares benefits, harms and costs resulting from two system level, mailed outreach strategies for promoting effective screening: the first strategy begins with a mailed fecal immune-histochemical test kit; the second begins with a mailed invitation for colonoscopy; both include centralized processes to assure guideline-based follow up. Project 3 characterizes organizational factors at the network and clinic level that contribute to completion of screening processes and examines which organizational factors modify relationships between social disadvantage and completion of guideline-based screening processes. Parkland, the sole safety-net provider in Dallas County, is a vertically integrated delivery system that includes 11 primary care clinics caring for 32,000 adults (50-64 yrs) and has a comprehensive electronic record through which eligibility for a test, test ordering, results, referrals, and treatment are ascertainable. Through these capabilities, the Screening Process Documentation Unit will: collect accurate, clinically detailed data on all relevant processes and outcomes across the screening process, and link to the ACCR Gold-Star Texas Cancer Registry; facilitate data transfers to the national data coordinating center; and work closely with the Shared Research Resources Core to provide all data needed for Projects 1-3.




Screening Beyond the Evidence: Patterns of Age and Comorbidity for Breast, Cervical, and Colorectal Cancer Screening.
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Unsatisfactory Fecal Immunochemical Tests for Colorectal Cancer Screening: Prevalence, Reasons, and Subsequent Testing.
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PMID: 37964449
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Improving Colorectal Cancer Screening in a Regional Safety-Net Health System over a 10-Year Period: Lessons for Population Health.
Authors: Halm E.A. , Nair R.G. , Hu E. , Wang L. , Lykken J.M. , Ortiz C. , Kim E.J. , Santini N.O. , Moran B. , Skinner C.S. .
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Provider- and Facility-Level Variation in Pre-Cancerous Cervical Biopsy Diagnoses.
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Gaps in the screening process for women diagnosed with cervical cancer in four diverse US health care settings.
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Cost Effectiveness of Mailed Outreach Programs for Colorectal Cancer Screening: Analysis of a Pragmatic, Randomized Trial.
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Reimbursement Matters: Overcoming Barriers to Clinical Trial Accrual.
Authors: Lee S.J.C. , Murphy C.C. , Gerber D.E. , Geiger A.M. , Halm E. , Nair R.G. , Cox J.V. , Tiro J.A. , Skinner C.S. .
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Anal Cancer and Anal Cancer Screening Knowledge, Attitudes, and Perceived Risk Among Women Living With HIV.
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Benefits and Harms of Hepatocellular Carcinoma Surveillance in a Prospective Cohort of Patients with Cirrhosis.
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ANALYSES OF PREVENTIVE CARE MEASURES WITH INCOMPLETE HISTORICAL DATA IN ELECTRONIC MEDICAL RECORDS: AN EXAMPLE FROM COLORECTAL CANCER SCREENING.
Authors: Zheng Y. , Corley D.A. , Doubeni C. , Halm E. , Shortreed S.M. , Barlow W.E. , Zauber A. , Tosteson T.D. , Chubak J. .
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Challenges and Approaches to Measuring Repeat Fecal Immunochemical Test for Colorectal Cancer Screening.
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A randomized trial of mail and email recruitment strategies for a physician survey on clinical trial accrual.
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Systematic Review of Prevalence, Risk Factors, and Risk for Metachronous Advanced Neoplasia in Patients With Young-Onset Colorectal Adenoma.
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Stakeholder engagement to initiate lung cancer screening in an urban safety-net health system.
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AGA Clinical Practice Guidelines on Management of Gastric Intestinal Metaplasia.
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Conceptual Model for Accrual to Cancer Clinical Trials.
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Colonoscopy Indication Algorithm Performance Across Diverse Health Care Systems in the PROSPR Consortium.
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Evaluating screening participation, follow-up and outcomes for breast, cervical and colorectal cancer in the PROSPR consortium.
Authors: Barlow W.E. , Beaber E.F. , Geller B.M. , Kamineni A. , Zheng Y. , Haas J.S. , Chao C.R. , Rutter C.M. , Zauber A.G. , Sprague B.L. , et al. .
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Time to Follow-up After Colorectal Cancer Screening by Health Insurance Type.
Authors: Breen N. , Skinner C.S. , Zheng Y. , Inrig S. , Corley D.A. , Beaber E.F. , Garcia M. , Chubak J. , Doubeni C. , Quinn V.P. , et al. .
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Screening initiation with FIT or colonoscopy: Post-hoc analysis of a pragmatic, randomized trial.
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Receipt of Colonoscopy Following Diagnosis of Advanced Adenomas: An Analysis within Integrated Healthcare Delivery Systems.
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Impact of a Clinical Decision Support System on Guideline Adherence of Surveillance Recommendations for Colonoscopy After Polypectomy.
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Cervical Cancer Screening Research in the PROSPR I Consortium: Rationale, Methods, and Baseline Findings from a U.S. Cohort.
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Cervical Cancer Burden and Opportunities for Prevention in a Safety-net Healthcare System.
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Social disadvantage, healthcare utilization, and colorectal cancer screening: Leveraging longitudinal patient address and electronic health records data.
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Cervical cancer screening among HIV infected women in an urban, U.S. safety-net healthcare system.
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Patterns and predictors of repeat fecal immunochemical and occult blood test screening in four large health care systems in the United States.
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Identifying quality improvement targets to facilitate colorectal cancer screening completion.
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Adherence to colorectal cancer screening measured as the proportion of time covered.
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Acute Myocardial Infarction Readmission Risk Prediction Models: A Systematic Review of Model Performance.
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Effect of Colonoscopy Outreach vs Fecal Immunochemical Test Outreach on Colorectal Cancer Screening Completion: A Randomized Clinical Trial.
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Recommendation of colorectal cancer testing among primary care patients younger than 50 with elevated risk.
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Racial/ethnic Differences In Obesity And Comorbidities Between Safety-net- And Non Safety-net Integrated Health Systems
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The utility of EMR address histories for assessing neighborhood exposures.
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Breast cancer screening initiation after turning 40 years of age within the PROSPR consortium.
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Racial/Ethnic Disparities in Colorectal Cancer Screening Across Healthcare Systems.
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PMID: 27050413
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Follow-Up of Abnormal Breast and Colorectal Cancer Screening by Race/Ethnicity.
Authors: McCarthy A.M. , Kim J.J. , Beaber E.F. , Zheng Y. , Burnett-Hartman A. , Chubak J. , Ghai N.R. , McLerran D. , Breen N. , Conant E.F. , et al. .
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PMID: 27132628
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Association Between Primary Care Visits and Colorectal Cancer Screening Outcomes in the Era of Population Health Outreach.
Authors: Halm E.A. , Beaber E.F. , McLerran D. , Chubak J. , Corley D.A. , Rutter C.M. , Doubeni C.A. , Haas J.S. , Balasubramanian B.A. .
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Influence of Age and Comorbidity on Colorectal Cancer Screening in the Elderly.
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PMID: 27344108
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Reasons For Lack Of Diagnostic Colonoscopy After Positive Result On Fecal Immunochemical Test In A Safety-net Health System
Authors: Martin J. , Halm E.A. , Tiro J.A. , Merchant Z. , Balasubramanian B.A. , McCallister K. , Sanders J.M. , Ahn C. , Bishop W.P. , Singal A.G. .
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Reducing Variation in the "Standard of Care" for Cancer Screening: Recommendations From the PROSPR Consortium.
Authors: Corley D.A. , Haas J.S. , Kobrin S. .
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PMID: 27089237
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Using lessons from breast, cervical, and colorectal cancer screening to inform the development of lung cancer screening programs.
Authors: Armstrong K. , Kim J.J. , Halm E.A. , Ballard R.M. , Schnall M.D. .
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PMID: 26929386
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Variation in Screening Abnormality Rates and Follow-Up of Breast, Cervical and Colorectal Cancer Screening within the PROSPR Consortium.
Authors: Tosteson A.N. , Beaber E.F. , Tiro J. , Kim J. , McCarthy A.M. , Quinn V.P. , Doria-Rose V.P. , Wheeler C.M. , Barlow W.E. , Bronson M. , et al. .
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PMID: 26658934
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Development Of The Parkland-ut Southwestern Colonoscopy Reporting System (cors) For Evidence-based Colon Cancer Surveillance Recommendations
Authors: Skinner C.S. , Gupta S. , Halm E.A. , Wright S. , McCallister K. , Bishop W. , Santini N. , Mayorga C. , Agrawal D. , Moran B. , et al. .
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Outreach Invitations For Fit And Colonoscopy Improve Colorectal Cancer Screening Rates: A Randomized Controlled Trial In A Safety-net Health System
Authors: Singal A.G. , Gupta S. , Tiro J.A. , Skinner C.S. , McCallister K. , Sanders J.M. , Bishop W.P. , Agrawal D. , Mayorga C.A. , Ahn C. , et al. .
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PMID: 26535565
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Cancer Models and Real-world Data: Better Together.
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Time to Colonoscopy after Positive Fecal Blood Test in Four U.S. Health Care Systems.
Authors: Chubak J. , Garcia M.P. , Burnett-Hartman A.N. , Zheng Y. , Corley D.A. , Halm E.A. , Singal A.G. , Klabunde C.N. , Doubeni C.A. , Kamineni A. , et al. .
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Predictors Of Guideline Concordance For Surveillance Colonoscopy Recommendations In Patients At A Safety-net Health System
Authors: Kahn B. , Freeland Z. , Gopal P. , Agrawal D. , Mayorga C.A. , Mithani R. , Skinner C.S. , Halm E.A. , Singal A.G. .
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PMID: 26376891
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Post-polypectomy Guideline Adherence: Importance Of Belief In Guidelines, Not Guideline Knowledge Or Fear Of Missed Cancer
Authors: Patel N. , Tong L. , Ahn C. , Singal A.G. , Gupta S. .
Source: Digestive Diseases And Sciences, 2015 Oct; 60(10), p. 2937-45.
PMID: 25947332
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Unifying screening processes within the PROSPR consortium: a conceptual model for breast, cervical, and colorectal cancer screening.
Authors: Beaber E.F. , Kim J.J. , Schapira M.M. , Tosteson A.N. , Zauber A.G. , Geiger A.M. , Kamineni A. , Weaver D.L. , Tiro J.A. , Population-based Research Optimizing Screening through Personalized Regimens Consortium .
Source: Journal Of The National Cancer Institute, 2015 Jun; 107(6), p. djv120.
PMID: 25957378
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