Paired Promotion of Colorectal Cancer and Social Determinants of Health Screening

Not Applicable

Completed

Brief Summary: This work is an implementation science study that examines different aspects of implementing a single intervention. The intervention consists of asking community health centers to implement an outreach strategy to screen patients for colorectal cancer and for social determinants of health in community health centers at the same contact point. These are both clinical targets that the CHCs feel that their patients need and want to offer at a higher rate. The intervention consists of outreach to patients in need of colorectal cancer screening (CRC) to offer fecal immunochemical test (FIT) screening and screening for social determinants of health (SDOH). In this implementation science study, the intervention is an evidence-based intervention being implemented in real-world clinical practice. The intervention is the outreach to offer FIT and SDOH, conducted by clinic staff. Both evidence-based screening activities-FIT and SDOH screening-are used in the practices included in the study but pairing them is intended to increase efficiency and patient-centeredness by addressing health related social needs that may impact patients' ability to engage in cancer screening. The study aims to test the effect of implementing the intervention on clinical and process outcomes. Clinical outcomes are CRC screening and SDOH screening. Analysis of process outcomes includes measuring what organizational factors influence implementation.

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

Have not participated in the implementation of the paired screening intervention

Arm && Interventions

Group	Intervention	Description
Paired Screening Intervention	Paired Screening Intervention	-

Primary Outcome Measures

Name	Time	Method
Conditional Odds Ratio of Patients Screened for Colorectal Cancer During Intervention Compared to Patients Screened During Usual Care	13 pre implementation months, 14 post-implementation months	Colorectal cancer screening completion by any guideline-based method. Adjusting for patient socio-demographics, comorbidities, number of healthcare visits, and secular trend. Documented screening in EHR for patients unscreened at the beginning of the step.
Conditional Odds Ratio of Patients Screened for Social Needs During Intervention Compared to Patients Screened During Usual Care	13 pre implementation months, 14 post-implementation months	Completion of social needs screening (collected as part of routine clinical care). Adjusting for patient socio-demographics, comorbidities, number of healthcare visits, and secular trend. Documented screening in EHR for patients unscreened at the beginning of the step.

Secondary Outcome Measures

Name	Time	Method
Number of FIT Kits Mailed	4 months post-implementation, 8 months post-implementation	Adoption measured by number of FIT kits mailed to patients. Data were summed to calculate a single value.
Number of Reminders Per FIT Mailing	4 months post-implementation, 8 months post-implementation	Adoption measured by number of reminders per FIT mailing to patients. Data were summed to calculate a single value.
Number of Reminders Per FIT Return	4 months post-implementation, 8 months post-implementation	Adoption measured by number of reminders per FIT returned. Data were summed to calculate a single value.

Locations (4): Brockton Neighborhood Health Center
🇺🇸
Brockton, Massachusetts, United States
Lowell Community Health Center
🇺🇸
Lowell, Massachusetts, United States
Manet Community Health Center
🇺🇸
Quincy, Massachusetts, United States
Harbor Health Services
🇺🇸
Boston, Massachusetts, United States