Alabama Colorectal Cancer Program (ACRCP) - The Alabama Department of Public Health Cancer Prevention and Control Division is applying for funding to reduce the colorectal cancer (CRC) rate through increased screening using stool-based tests and colonoscopy, and appropriate follow-up and treatment of individuals who have an abnormal test result. ACRCP aims to improve CRC screening rates for Alabama residents who are at risk for CRC and seek primary care in the state’s Federally Qualified Health Care Centers (FQHCs). For the 42 percent of Alabamians who reside in rural areas, FQHCs are generally the only primary care health facility available, serving over 340,000 patients in 2018, according to HRSA. In order to ensure effective, sustainable process change that impacts the priority population, FQHCs and specific clinic sites in each system were carefully selected after evaluating each county’s poverty rates, insurance coverage, CRC incidence and mortality, and CRC late-stage data, as well as historically successful relationships and demonstrated commitment. Further criteria were high-volume, proximity to the partnering hospitals, and active engagement with system-level administration and quality assurance leadership. ACRCP will partner with two FQHC systems - Rural Health Medical Program (RHMP) and Quality of Life Health Services (QOL) - along with their associated hospitals, Whitfield Regional Hospital and Gadsden Regional Medical Centers. Counties of focus include Clarke, Etowah, Marengo, and Wilcox. These systems are located in rural areas with high unemployment, low education levels, and limited healthcare access. In 2023, RHMP and QOL had a CRC screening rate of 27 percent and 11percent, respectively. Both FQHCs are below the 60 percent screening threshold. During Year 1, RHMP efforts will target three clinics in the Whitfield Regional Hospital catchment area. Two have successfully collaborated with the Alabama Breast and Cervical Cancer Early Detection Program to improve breast and cervical cancer screening rates in the past. QOL’s efforts will target the main office/clinic near Gadsden Regional Medical Center. The Division has considerable experience in systems change, implementation of evidence-based interventions, data monitoring, and evaluation. Due to long-term staff, experience and expertise have remained in the Division. For 10 years, Division staff have worked in eight FQHCs to facilitate process improvement and implement EBIs to increase cancer screening rates for breast, cervical, and colorectal cancer.
