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Developing an intervention to improve follow-up of abnormal fecal immunochemical test results in a safety-net population using a mixed methods approach

Award Number: K08CA241296
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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Project Summary Rachel Issaka, MD, MAS’ long-term career goal is to become an independent researcher and leader in developing, implementing, and evaluating interventions to reduce colorectal cancer (CRC) mortality in medically underserved populations. She has identified improving follow-up of abnormal fecal immunochemical test (FIT) results as a critical issue to address to achieve this goal. This proposal describes a 5-year comprehensive program of training and mentored research for an academic career in health outcomes research. The research agenda is in line with one of NCI’s five scientific goals: to improve cancer prevention and control. In this goal, advancing health care equity in medically underserved populations is an area of special focus. While Dr. Issaka has a strong background in clinical gastroenterology and safety-net systems-level research, this K08 will provide key training in advanced multilevel statistical modeling, qualitative research methods, mixed methods research, and intervention development. FIT is promoted over colonoscopy for CRC screening in federally qualified health centers (FQHCs) and safety-net health systems due to patient preference and limited colonoscopy resources. For FIT-based screening to effectively reduce CRC-mortality, abnormal results must be followed by a diagnostic colonoscopy. However, FQHCs and safety-net health systems do not consistently track follow-up of abnormal FIT results and failure to complete a diagnostic colonoscopy increases CRC-mortality by up to 3-fold. Research suggests approximately 50% of safety-net patients with an abnormal FIT do not complete a diagnostic colonoscopy within 1 year of their result. This highlights the importance of identifying and describing the barriers to diagnostic colonoscopy completion after abnormal FIT results in order to develop effective interventions. The study’s specific aims are: (1) using mixed methods, identify the potentially modifiable patient, provider, and clinic- level barriers to diagnostic colonoscopy in patients with abnormal FIT results in a large safety-net health system; and (2) based upon intervention targets identified in Aim 1, develop a pilot intervention to improve diagnostic colonoscopy completion in a safety-net population with abnormal FIT results. Dr. Issaka’s mentorship team including world-renowned gastroenterologists, health services researchers, qualitative and mixed methods experts and implementation scientists will provide experiential guidance to complement her didactic training. These factors in addition to the supportive research environments at the Fred Hutchinson Cancer Research Center and the University of Washington, will enable her to achieve the proposed project aims. Upon completion of the proposed research and training, Dr. Issaka will submit a competitive R-level grant application to test the pilot intervention in a randomized trial and will possess the skills and experience to make sustained and impactful contributions to reduce CRC-mortality through evidence-based interventions that improve follow-up of abnormal FIT results.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $223,603 )
2023	2023	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	001	6	7/27/2023	NON-COMPETING CONTINUATION	$223,603
2023	2022	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	000	5	11/29/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $223,603

Issue Date FY: 2022 ( Subtotal = $225,708 )
2022	2022	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	004	5	8/16/2022	NON-COMPETING CONTINUATION	$225,708
2022	2021	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	005	4	9/16/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$0
2022	2021	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	001	4	6/9/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$85,083
2022	2021	FRED HUTCHINSON CANCER CENTER	1100 FAIRVIEW AVE N	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	003	4	8/8/2022	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$5,359
2022	2021	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	000	3	6/9/2022	NON-COMPETING CONTINUATION	-$85,083
2022	2021	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	002	3	8/8/2022	NON-COMPETING CONTINUATION	-$5,359
														Subtotal = $225,708

Issue Date FY: 2021 ( Subtotal = $219,131 )
2021	2021	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	000	3	8/20/2021	NON-COMPETING CONTINUATION	$219,131
														Subtotal = $219,131

Issue Date FY: 2020 ( Subtotal = $158,736 )
2020	2020	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	001	2	8/7/2020	NON-COMPETING CONTINUATION	$158,736
2020	2019	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	000	1	2/27/2020	NEW	$0
														Subtotal = $158,736

Issue Date FY: 2019 ( Subtotal = $288,786 )
2019	2019	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	001	1	9/6/2019	NEW	$0
2019	2019	FRED HUTCHINSON CANCER RESEARCH CENTER	1100 FAIRVIEW AVE N J6-300	SEATTLE	WA	98109	KING	USA	Cancer Research Manpower	000	1	8/20/2019	NEW	$288,786
														Subtotal = $288,786

Grand Total All Awards = $1,115,964

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Developing an intervention to improve follow-up of abnormal fecal immunochemical test results in a safety-net population using a mixed methods approach

Award Number: K08CA241296

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

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