Ohio Community Health Center Colorectal Cancer Screening Program - Applicant Organization: Ohio Association of Community Health Centers Project Title: Ohio Community Health Center Colorectal Cancer Screening Program The Ohio Association of Community Health Centers (OACHC) supports all of Ohio’s 60 Federally Qualified Health Centers (FQHCs) and FQHC Look-Alikes, providing care to just under one million Ohioans across 550+ sites in 76 of Ohio’s 88 counties. Through this network, OACHC will implement a statewide initiative to expand colorectal cancer (CRC) screening among Ohio residents aged 45 to 75 years old served by FQHCs. The CRC screening program will engage a new cohort of five (5) FQHCs each program year (25 total), prioritizing health centers with CRC screening rates below 60%. With guidance and technological infrastructure provided by OACHC, each health center will implement multi-component evidence-based interventions (EBIs) to improve screening uptake, patient follow-up, and early-stage CRC diagnosis. The purpose of the program is to improve long-term CRC screening and early detection statewide by increasing screening rates among populations less likely to seek preventive care. Ohio CRC mortality is currently 10% higher than the U.S. on average, and CRC screening prevalence among lower-income populations served by FQHCs (43.3%) is significantly lower than among Ohioans on average (70.2%) (OACHC, 2023; Ohio Cancer Profile, 2023). OACHC will support participating FQHCs by integrating a minimum of three EBIs into existing clinical workflows, including patient and provider reminders, provider feedback, and strategies to reduce structural barriers such as transportation and cost limitations. Each FQHC will identify a CRC Screening Champion responsible for overseeing implementation, staff training, and CRC data reporting. OACHC will develop a specific CRC dashboard in the Ohio Data Integration Platform (ODIP), utilizing the existing Azara data visualization system, implemented at each participating clinic, and will implement data reporting integrations within each health center’s electronic health record (EHR) to monitor stool test return rates, follow-up colonoscopy completion, and trends in early-stage CRC diagnoses, and other high-quality, clinic-level data. OACHC will conduct monthly practice facilitation and technical assistance (TA) meetings to ensure high-quality data reporting, provide ongoing implementation support and health center accountability, identify areas for quality improvement, and foster peer-to-peer learning between health centers. OACHC has decades of experience in facilitating these types of practice transformation efforts across a variety of preventive and chronic disease foci. Partner clinics will also formalize referral pathways and agreements, as needed, to colonoscopy and treatment providers to ensure patients with abnormal test results receive appropriate follow-up care. By the end of the project period, OACHC will achieve measurable increases in CRC screening among partner practices through evidence-based screening methods, as well as follow-up colonoscopy completion and linkage to care when necessary. Program outcomes will include at least a 10% increase in stool-based test return prevalence among partner practices within five (5) years. Partner practices will also achieve at least a 25% colonoscopy completion prevalence among patients requiring diagnostic follow-up, demonstrating a one-year increase from baseline across all participating health centers. Activities will lead to increased implementation and enhancement of EBIs, higher CRC screening rates, and more early-stage CRC diagnoses—ultimately reducing CRC incidence and mortality among Ohioans served by FQHCs.
