According to the American Cancer Society, consistent with national trends, it is estimated that in 2020 colorectal cancer will be the 4th most commonly diagnosed cancer and the 3rd leading cause of cancer-related deaths in Rhode Island. Despite increases in screening rates over the past 2 decades, there remains a disparity between statewide screening rates (according to the Behavioral Risk Factor Surveillance System - BRFSS) and screening rates of underserved populations, especially from Federally Qualified Health Centers (FQHCs) and Free Clinics in RI. The goal of the proposed project is to address this disparity by improving colorectal cancer screening rates and outcomes among target, underserved Rhode Islanders aged 50 to 75. To achieve this goal, the Rhode Island Department of Health (RIDOH), the Rhode Island Health Center Association (RIHCA), and Brown University’s School of Public Health will work with health systems and clinics, Rhode Island’s Health Equity Zone Initiative, community-based organizations (CBOs), hospital cancer centers, and community members to do the following:
1. Implement evidence-based interventions (EBIs) in 7 FQHCs, 2 Free Clinics, 1 tribal organization, and 1 correctional facility to facilitate access to colorectal cancer screening, diagnostic, and treatment services for their patients, aged 50 to 75. These interventions and supporting strategies will include Provider Assessment and Feedback, Patient Reminders, Provider Reminders, Reducing Structural Barriers, Use of Small Media, and Patient Navigation.
2. Utilize CDC-defined EBIs and supporting strategies to achieve program outcomes. These will include establishing partnerships to support implementation of EBIs in health systems and primary care clinics, facilitating patients’ linkage to diagnostic and follow-up services, and performing quality improvement, monitoring, and evaluation of all program activities.
3. Develop sustainable colorectal health awareness and educational campaigns tailored to at-risk communities.
The proposed project takes an integrated, population-based approach that builds off existing partnerships and projects throughout Rhode Island to increase clinic-level CRC screening rates and address disparities in CRC morbidity and mortality.