Increasing Colorectal Cancer Screening and Follow-up in Rural Idaho FQHCs - Comagine Health, in partnership with the Idaho Community Health Center Association (ICHCA), proposes a comprehensive, evidence-based initiative to increase colorectal cancer (CRC) screening rates among rural Idahoans aged 45-75 receiving care at Federally Qualified Health Centers (FQHCs). This project directly addresses Idaho’s CRC screening gap, where rates lag below national averages, especially in rural populations. The initiative targets five FQHCs with screening rates below the national average collectively serving 121,519 patients, focusing on evidence-based interventions (EBIs) and sustainable quality improvement (QI) practices. Purpose: To increase CRC screening rates, reduce screening disparities, and improve follow-up care in rural Idaho through evidence-based interventions and system-level improvements. Strategies and Activities: Comagine Health will employ a phased, cohort-based model over five years, engaging two cohorts of FQHCs. Cohort 1 will participate for 2.5 years, then transition to a mentorship role for Cohort 2. Cohort 2 will participate for the final 2.5 years. The project will implement the following core strategies: • Collaborative Outreach & Readiness Assessment: Identify and recruit FQHCs, conduct readiness assessments, and engage community-based organizations to reduce structural barriers (e.g., transportation and financial assistance for colonoscopies). • Learning Collaborative for EBI Implementation: Facilitate quarterly learning sessions and provide monthly 1:1 technical assistance using the IHI Breakthrough Series model. EBIs include patient reminders, provider reminders, provider assessment and feedback, and patient navigation. • Monitoring and Evaluation: Track CRC screening and follow-up data via the Azara population health system (which utilizes EHR data), conduct regular data validation, and produce quarterly performance reports. • Support for Test Completion and Follow-up: Provide uninsured patients with free stool test kits and limited financial support for colonoscopies. Establish partnerships with endoscopy centers to ensure timely follow-up. Outcomes: By project end, Comagine Health expects to achieve: • Increased implementation and enhancement of EBIs across all participating FQHCs. • Higher rates of stool test returns and colonoscopy completions. • A measurable increase in overall CRC screening rates among patients aged 45-75. • Enhanced FQHC capacity for data-driven quality improvement and sustainable EBI integration. Evaluation and Impact: The project will use a mixed-methods evaluation framework, combining quantitative data from EHR systems with qualitative insights from FQHCs. Performance will be measured quarterly, focusing on EBI implementation, screening rates, and follow-up completion. Continuous quality improvement cycles will drive mid-course adjustments and sustain progress. Collaboration and Sustainability: Comagine Health will partner closely with ICHCA, participating FQHCs, and the Idaho Department of Health and Welfare (IDHW). Cohort 1 will mentor Cohort 2, fostering peer-to-peer learning and ensuring long-term sustainability. Post-project, participating FQHCs will maintain QI activities, supported by data-sharing agreements and ongoing technical assistance from ICHCA. This initiative aligns with CDC’s mission to increase CRC screening rates, address health disparities, and promote evidence-based public health practices.
