Rhode Island Colorectal Cancer Screening Program - Consistent with national trends, colorectal cancer (CRC) remains the fourth most commonly diagnosed cancer and the third leading cause of cancer-related deaths in Rhode Island. Despite a statewide CRC screening rate of 74.3% (BRFSS, 2022), disparities persist among Medicaid beneficiaries (45.1%), uninsured individuals (25.2%), and adults aged 45-54 (34.8%). The Rhode Island Department of Health (RIDOH) seeks to address this disparity by increasing access to screening, enhancing follow-up testing and care, and implementing evidence-based interventions (EBIs) across priority populations. Through CDC-RFA-DP25-0012 funding, RIDOH will strengthen partnerships with health systems, safety-net clinics, supporting partners, community organizations, and other RIDOH programs to improve screening efforts, integrate EBIs and patient navigation services, and strengthen provider engagement. Through this initiative, RIDOH aims to: 1) Increase CRC screening rates to 60% for Medicaid beneficiaries, 50% for uninsured individuals, and 58% for adults aged 45-54, screening 14,000 additional at-risk Rhode Islanders; 2) Establish and strengthen existing partnerships with 14 health systems, including 8 Federally Qualified Health Centers, 4 safety-net clinics, 1 tribal health center, and 1 correctional facility serving priority populations; and 3) Expand patient navigation and referral systems to improve access to and completion of CRC screening, diagnostic follow-up, and treatment. Implementation Strategies. To achieve program outcomes, RIDOH will utilize CDC-defined evidence-based strategies, assess state health systems, establish partnerships for EBI implementation, and integrate EBIs into clinic workflows. RIDOH will contract with 14 partner health systems, conduct clinic readiness assessments, and develop Clinic Implementation Plans (CIPs) tailored to each site’s needs. Quarterly Quality Improvement (QI) meetings will assess progress, address challenges, and refine strategies. Each partner clinic will implement at least three multi-component EBIs and patient navigation, integrating patient and provider reminders, provider assessment and feedback, and structural barrier reduction into workflows. Partner clinics will designate a CRC Screening Champion and key staff to oversee EBI implementation and collaborate with RIDOH’s technical assistance (TA) partners to optimize electronic health record (EHR) tracking. RIDOH will implement a comprehensive Evaluation and Performance Measurement Plan (EPMP) to track screening trends and ensure data-driven decision-making. Clinics will submit quarterly data reports, receive EHR enhancement support, and participate in QI meetings to improve workflow efficiency and program implementation. To improve screening completion and follow-up, RIDOH will expand patient navigation services, facilitate stool test completion and colonoscopy referrals, and provide financial support for 200-250 follow-up colonoscopies annually for uninsured patients, per CDC guidelines. EHR tracking improvements will enhance monitoring of test return rates, diagnostic follow-up, and referral-to-completion times. Additionally, RIDOH will develop sustainable CRC health awareness and educational campaigns tailored to at-risk communities to improve screening uptake and patient engagement. Long-Term Impact. By leveraging partnerships, optimizing workflows, and addressing barriers to care, this initiative will expand access to CRC screening, improve early detection, and reduce cancer-related disparities statewide. RIDOH’s integrated approach will enhance provider and community engagement and contribute to long-term reductions in CRC incidence and mortality across Rhode Island.
