Changing Health Systems Using Evidence-based Interventions to Increase Colorectal Cancer Screening in Maine - Colorectal cancer is the second leading cause of cancer-related deaths in the United States1, but also the one of the most preventable. In 2022, Maine had 248 people die from colorectal cancer, with higher mortality rates in our rural counties. Maine is the most rural state in the country, so reaching those patients who reside outside of metropolitan areas is paramount since they represent such a large portion of our population. Colorectal cancer screening rates in Maine vary by county, insurance status, income level, and age. Our target population for this grant are those 45-75 years old, un-/underinsured, living in rural areas, identify as farm workers, and those below the federal poverty level. For nearly ten years, the Maine Colorectal Cancer Control Program (ME CRCCP), a program within the Division of Disease Prevention of the Maine Center for Disease Control and Prevention, has provided leadership and coordination of evidence-based strategies to increase colorectal cancer screening rates, particularly for those experiencing health disparities in our Federally Qualified Health Centers. The ME CRCCP aims to address these disparities by building on the success of the current screening grant through strengthening partnerships, creating new relationships with community-based organizations and supporting the implementation of evidence-based interventions (EBIs) at participating clinics. The purpose of the program is to increase colorectal cancer screening rates among our focus populations, expand our reach to additional clinics, provide support for sustainable EBI implementation activities and reduce screening rate disparities across the state. ME CRCCP will conduct the following activities to meet our short and long-term objectives and strategies outlined in the program logic model: Establish and enhance partnerships between FQHCs, supporting partners and the community: ME CRCCP will partner with a variety of organizations to develop an effective infrastructure to support this colorectal cancer screening grant across the state. We plan to strengthen relationships established in the current grant and expand reach with new partnerships working with target populations. Support implementation of EBIs to increase CRC screening: With the support of partners, ME CRCCP will ensure all participating clinics successfully implement at least three multi-component evidence-based interventions (EBI). We will work closely with these clinics to create EBI work plans that help to maximize the use of electronic health records, identify and engage a screening champion, develop or enhance a comprehensive CRC screening policy, and outline technical assistance support resources. Conduct Monitoring and evaluation that ensure data quality: ME CRCCP will utilize ongoing monitoring and evaluation to improve the program throughout the grant cycle. We will develop a comprehensive five-year evaluation plan and support participating clinics in completion of annual program reporting and evaluation. The program will also continue the use of clinic-specific evaluations for dispersing information and program improvements. Support completion of stool-based tests, as well as colonoscopies. ME CRCCP will work closely with partner clinics to provide technical assistance and support in completion of CRC screenings, including tracking follow-up colonoscopies. We will outreach to local hospitals to communicate and promote the work of the grant and opportunities to collaborate.
