Friday, January 27, 2023
1/27/2023
The geographic area covered by this colorectal cancer screening project is the state of Alaska in which 66% of the population lives in urban areas and 33.98% lives in rural/remote/frontier areas (US Census Bureau: 2010 Census Urban and Rural Classification and Urban Area Criteria). The target population of this project are the 18,769 patients ages 50-75 of the 13 Alaska Community Health Centers (CHCs) in Alaska’s Health Center Controlled Network (HCCN), the Alaska Quality Improvement Network (AQuIN). There are 61,199 patients who receive their primary care at these clinics, 86% of whom have incomes under 200% of the federal poverty level (FPL), and 45% have incomes under 100% FPL. More than 29% of these patients are beneficiaries of the Alaska Medicaid Program. The 13 CHCs in the HCCN are far-flung across Alaska; therefore, the patients are a rich mix of ethnic and racial backgrounds and heritage. With that diversity comes a degree of health disparities, as well. Current colorectal cancer screening rates (CY2018 UDS) in Alaska CHCs for this patient population is 34.18% compared to 44.11% in the rest of the nation. Through this project, the Alaska Primary Care Association (APCA) – HRSA grant recipient of both the PCA and HCCN programs - intends to increase colorectal cancer (CRC) screening rates in Alaska CHCs that provide clinical services to populations with low CRC screening by implementing clinic-appropriate evidence-based interventions (EBIs). APCA will build on and maximize the infrastructure developed and realized over the past five years which has equipped 13 CHCs with a uniform, powerful population health and data analytics platform called the Data Reporting and Visualization System, or DRVS (“drives”). APCA will establish partnerships with health system and primary care clinics; use APCA Quality Improvement (QI) experts to support implementation of evidence-based interventions (EBIs); conduct QI readiness assessments of partner primary care clinics; implement EBIs shown to increase screening rates; facilitate patients' linkage to follow-up colonoscopy; and provide training on and encourage data quality for effective program monitoring and evaluation. Through assessment, EBI identification and customized action plans, trained clinic staff, and additional educational and testing resources, Alaska CHCs will increase CRC screening rates among our state’s most vulnerable Alaskans. As a result of this project, APCA expects to measure an increase in colorectal cancer screening rates among the CHC project participants as identified in individual clinic’s action plans and aim statements, achieving a minimum 10% increase per year over the five years in each clinic. According to the November 2018 edition of the GastroJournal.org, initiation of organized CRC screening (annual fecal immunochemical testing and colonoscopy) increased the up to date status of screening, from 38.9% in 2000 to 82.7% in 2015, and was associated with a 25.5% reduction in annual CRC incidence and a 52.4% reduction in cancer mortality. A baseline CRC screening rate and early CRC diagnosis rate at participating health centers will be calculated using DRVS as each one is onboarded to the project. It is anticipated that, over time, better screening will result in increased detection and removal of suspicious lesions, diagnosis of early stage CRC, and the long-term outcome of decreased CRC incidence and mortality among the population reached by program activities. To sustain these positive outcomes of increased screening and decreased late-stage disease, APCA is committed to working with CHC staff and leadership to establish and entrench long-term policies and procedures that make the practice of screening permanent.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
