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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
26
The intervention is the implementation of a paired outreach strategy to patients in need of colorectal cancer screening to offer FIT testing and to complete screening for social determinants of health. These screening activities are part of routine practice but the intervention that is being implemented is the paired outreach for both CRC screening and SDOH screening.
Harbor Health Services
Boston, Massachusetts, United States
Brockton Neighborhood Health Center
Brockton, Massachusetts, United States
Lowell Community Health Center
Lowell, Massachusetts, United States
Manet Community Health Center
Quincy, Massachusetts, United States
Conditional Odds Ratio of Patients Screened for Colorectal Cancer During Intervention Compared to Patients Screened During Usual Care
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.
Time frame: 13 pre implementation months, 14 post-implementation months
Conditional Odds Ratio of Patients Screened for Social Needs During Intervention Compared to Patients Screened During Usual Care
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.
Time frame: 13 pre implementation months, 14 post-implementation months
Number of FIT Kits Mailed
Adoption measured by number of FIT kits mailed to patients. Data were summed to calculate a single value.
Time frame: 4 months post-implementation, 8 months post-implementation
Number of Reminders Per FIT Mailing
Adoption measured by number of reminders per FIT mailing to patients. Data were summed to calculate a single value.
Time frame: 4 months post-implementation, 8 months post-implementation
Number of Reminders Per FIT Return
Adoption measured by number of reminders per FIT returned. Data were summed to calculate a single value.
Time frame: 4 months post-implementation, 8 months post-implementation
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