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Reducing Disparities in CRC screening rates for rural, frontier, and Native American populations in North Dakota

Award Number: NU58DP006762
ORGANIZATION: NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION & HEALTH PROMOTION
OPDIV: CDC
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: HEALTH SERVICES
PERIOD OF PERFORMANCE START DATE: 06/30/2020
PERIOD OF PERFORMANCE END DATE: 08/29/2025

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Reducing Disparities in CRC screening rates for rural, frontier, and Native American populations in North Dakota - Background/Need: Quality Health Associates of North Dakota (QHA) is submitting this application to participate in the Public Health and Health Systems Partnerships to Increase Colorectal Cancer Screenings in Clinical Settings. In North Dakota there are significant disparities in colorectal cancer (CRC) screening rates between people residing in urban areas of the state and people, including a significant number of Native Americans, residing in rural and frontier counties. The statewide screening rate in North Dakota according to the Behavioral Risk Factor Surveillance System (BRFSS) data is 66.9%. However, population and geographic analysis tells a different story. Medicare data from 2018 confirms the average CRC screening rate for people aged 50-75 who reside in rural, frontier and reservation areas of North Dakota is 44 percent. Objectives/Purpose: The purpose of this program is to help North Dakota’s primary care clinics increase CRC screening rates for rural, frontier and Native American populations, thereby reducing the incidence and late-stage diagnosis of colorectal cancer and increasing the number of lives saved. Approach: In year one QHA will work with 10 primary care clinics located in frontier and rural counties in North Dakota. Approximately 6,500 age-appropriate individuals in these counties have not been screened for colorectal cancer. QHA will work with 6-8 additional rural and frontier clinics in each subsequent year with potential to impact 30,000 individuals eligible for screening. QHA’s strategy includes completion of comprehensive readiness assessments and development of clinic-specific action plans for implementing at least two evidence-based interventions to address CRC screening. QHA staff will support the clinic by providing both individual technical assistance and a rapid-action collaborative structure. QHA will share resources, tools and materials; conduct frequent site visits and coaching calls to assess progress; identify barriers; and develop mitigation strategies. In the rapid-action collaborative, the clinic will work in small groups for education, identifying barriers and successes, and sharing best practices. QHA staff will help clinic staff leverage their electronic health records (EHRs) to collect and report CRC screening program measures. This assistance will include a robust quarterly data quality validation and feedback process. The CRC screening program will be supported by a comprehensive internal quality control and program evaluation structure. Staffing and Capacity: QHA is experienced in conducting successful large- and small-scale programs to improve health and health care in North Dakota and has strong working relationships with health care providers and external stakeholders. QHA’s CRC Screening Program Team will include experienced project managers and quality improvement specialists with nursing and public health background and Health Information and Information Technology professionals well versed in leveraging EHRs to collect quality and population health data. The quality of the CRC screening program will be supported by a robust internal quality control plan and a CRC Screening Program Evaluation Team consisting of internal and external partners and stakeholders with experience in conducting program evaluation.


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: 2025 ( Subtotal = $0 )
2025	2024	QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA	41 36TH AVE NW	MINOT	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	02	5	6/23/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $412,820 )
2024	2024	QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA	41 36TH AVE NW	MINOT	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	00	5	6/11/2024	NON-COMPETING CONTINUATION	$412,820
2024	2024	QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA	41 36TH AVE NW	MINOT	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	01	5	6/17/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2024	2023	QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA	41 36TH AVE NW	MINOT	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	01	4	6/13/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $412,820

Issue Date FY: 2023 ( Subtotal = $433,535 )
2023	2023	QUALITY HEALTH ASSOCIATES OF NORTH DAKOTA	41 36TH AVE NW	MINOT	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	00	4	5/19/2023	NON-COMPETING CONTINUATION	$433,535
														Subtotal = $433,535

Issue Date FY: 2022 ( Subtotal = $418,876 )
2022	2022	Quality Health Associates of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	00	3	5/19/2022	NON-COMPETING CONTINUATION	$418,876
														Subtotal = $418,876

Issue Date FY: 2021 ( Subtotal = $410,017 )
2021	2021	Quality Health Associates Of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	00	2	5/12/2021	NON-COMPETING CONTINUATION	$410,017
2021	2021	Quality Health Associates Of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	01	2	9/17/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2020	Quality Health Associates Of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	00	2	5/12/2021	NON-COMPETING CONTINUATION	$0
2021	2020	Quality Health Associates Of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	01	2	9/17/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
2021	2020	Quality Health Associates Of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	01	1	3/1/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $410,017

Issue Date FY: 2020 ( Subtotal = $400,000 )
2020	2020	Quality Health Associates of North Dakota	41 36 Ave NW	Minot	ND	58703	WARD	USA	Organized Approaches to Increase Colorectal Cancer Screening	00	1	6/11/2020	NEW	$400,000
														Subtotal = $400,000

Grand Total All Awards = $2,075,248

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Reducing Disparities in CRC screening rates for rural, frontier, and Native American populations in North Dakota

Award Number: NU58DP006762

ORGANIZATION: NATIONAL CENTER FOR CHRONIC DISEASE PREVENTION & HEALTH PROMOTION

OPDIV: CDC

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: HEALTH SERVICES

PERIOD OF PERFORMANCE START DATE: 06/30/2020

PERIOD OF PERFORMANCE END DATE: 08/29/2025

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