The purpose of this project is to increase colorectal screening rates of patients ages 50-75 using evidence-base interventions in primary care clinics that provide clinical services to populations with low colorectal cancer (CRC) screening rates. Specifically, clinic-originated interventions targeting both providers’ and patients’ behaviors will be addressed in selected Federally Qualified Health Centers (FQHCs) with clinics in rural areas across Missouri. A collaborative of two academic cancer centers (University of Missouri Ellis Fischel Cancer Center and Washington University Siteman Cancer Center) and the Missouri Department of Health and Senior Service’s Comprehensive Cancer Control Program will organize, facilitate, and evaluate innovative community collaborations in rural areas served by FQHCs delivering evidence-based interventions leading to improvement in CRC screening rates. Resources provided by the grant will be used to organize and build upon existing resources to establish an ‘information warehouse’ to facilitate networking among primary care clinics involved in cancer screening and increase utilization of evidence-based interventions. Project team leadership will assure that each FQHC clinic will have a tailored local implementation strategy that includes partnerships with local county health departments and local University of Missouri Extension community engagement specialists. In combination the grant activities will: 1) establish partnerships with health systems and primary care clinics to implement at least two of four evidence based interventions (EBIs) recommended in The Community Guide (client reminders, provider reminders, reduction of structural barriers, and provider assessment and feedback); 2) establish partnerships with organizations that provide expertise to support the implementation of EBIs in primary care clinics; 3) conduct a formal assessment of each clinic's capacity/readiness to implement EBIs; 4) utili
ze the clinic assessment to select appropriate EBIs to implement; 5) provide resources to partner clinics to provide and support completion of follow-up colonoscopies after a positive or abnormal screening test; and 6) collect and submit high-quality clinic-level data including baseline and annual CRC screening rates.