With UNC Lineberger Comprehensive Cancer Center in Chapel Hill, RCCHC is proposing to use AxCS funds to increase the number and percentage of patients screened for colorectal cancer and to increase the number of patients assisted with accessing appropriate follow-up care including colonoscopy appointment within 30 days of abnormal FIT results. The proposed project will be offered to all RCCHC patients throughout our 5 clinic service delivery network in Hertford, Bertie, Gates, Northampton and Washington counties. We will deliver FIT screening, through mailed and mobile unit outreach, to 2200 patients. We expect that 22% or up to 484 patients per year will complete a test received through the mailed FIT outreach effort. We believe that mailed FIT outreach can increase RCCHHC's CRC screening rate by 4 percentage points. We will also distribute FIT through the new RCCHC mobile health unit serving marginalized and vulnerable populations including public housing and seasonal agricultural workers, and anticipate up to 200 eligible patients each year will participate in FIT testing. UNC Lineberger Comprehensive Cancer Center will provide technical assistance and training to Roanoke Chowan Community Health Center (RCCHC) to plan and implement a multi-level colorectal cancer screening effort. The Lineberger navigator will ensure that the number of RCCHC patients that receive assistance from a patient navigator to access appropriate follow up care increases from 0 (no navigator currently in place) to approximately 50 patients per year. The Lineberger navigator will support the RCCHC outreach and navigation program to deliver services. The RCCHC Community Health Worker will work with the mobile health teams to identify potential eligible patients and assist the navigator with follow up as needed. The proposed AxCS project will reduce barriers by providing access to CRC screening through a mailed FIT intervention that can be done in the privacy of
the patient’s bathroom. The test instructions and educational information will be provided in low literacy English and Spanish. Following abnormal results, intensive navigation services will address common obstacles such as transportation, linguistic interpretation, acquisition of bowel prep materials, and cost of colonoscopy. These resources are available through our partnership with Lineberger CCC and through services already provided by RCCHC (transportation, interpretation, medication assistance) and hospital programs for the uninsured. UNC Lineberger has partnered with RCCHC to address CRC screening since 2018 through the NC ACCSIS initiative and has committed to partner with us again to scale our CRC screening efforts through the AxCS Accelerating Cancer Screening opportunity. This proposal will leverage the efforts of OCHIN, a Health Care Controlled Network and Eastern AHEC, a longstanding partner working with RCCHC on practice support and improvement efforts. EAHEC will assist with ensuring that RCCHC develops workflows and other tracking systems to ensure effective navigation of patients to colonoscopy and treatment and OCHIN will provide technical programming support to ensure operational efficacy flowing data from and into the Electronic Health Records of our FIT eligible patients.