Changing Health Systems Using Evidence-based Interventions to Increase Colorectal Cancer Screening - Colorectal cancer (CRC) is one of the leading causes of cancer related death in the nation for men and women combined, an alarming fact since regular screening has been shown to effectively prevent CRC or detect cancer at an early stage when it is more favorable to treatment. Historically, Kentucky has reported some of the highest CRC incidence and mortality rates in the nation. This trend persists today along with low screening prevalence. Federally qualified health centers (FQHCs) in Kentucky reported an average colorectal cancer screening prevalence below 50% in 2023.1 The Kentucky Department for Public Health’s (KDPH) Colon Cancer Program, along with contracted partners, aim to utilize this cooperative agreement to increase colorectal cancer screening prevalence in partnered health systems who serve Kentucky communities in areas of the state where CRC screening resources are limited, such as rural parts of western and eastern Kentucky. KDPH used population-based data with health tracking data to identify areas of need and potential health systems to partner with KDPH to perform the interventions. Results of the initial investigation indicate Kentucky residents in rural communities have higher CRC incidence and mortality rates; therefore, these populations were chosen to focus intervention efforts. Health systems that met program criteria were interviewed, and preliminary colorectal cancer screening clinic data was reviewed. KDPH contracted with six health transformation expert organizations to form the grant leadership team. A site visit, readiness assessment, workflow analysis and electronic health record (EHR) data validation will be conducted by the leadership team within the first six months of program year 1. Monthly technical assistance meetings with each health system’s leadership and provider champion will be facilitated by leadership. During technical assistance meetings, monthly clinic level screening data will be reviewed such as screening prevalence, colonoscopy or treatment referrals, follow-up colonoscopy completion rates, fecal test returns and patient navigation measures. Partners will provide guidance on evidence-based intervention (EBI) implementation or improvement as well as various methods of professional development trainings/presentations. Annual data will be collected and submitted to the CDC. Through various interventions, within partnered clinics, this program aims to improve adoption of three or more EBIs; enhance CRC screening data quality from EHR systems; increase at-home screening kit return and colonoscopy completion rates; and increase overall CRC screening prevalence. Decreasing colorectal cancer mortality rates through prevention is the ultimate goal of this program. To summarize, this cooperative agreement would allow the state of Kentucky to provide crucial colorectal cancer screening interventions to health systems that serve some of the most vulnerable and underserved populations in the Commonwealth. 1. Kentucky Health Center Program Uniform Data System (UDS) data. (2023). https://data.hrsa.gov/tools/data-reporting/program-data/state/KY
