Improving Guideline-Recommended Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC): Implementing a Patient Navigation and Practice Facilitation Intervention to Promote Health Equity

Kathryn M. Glaser (), Christina R. Crabtree-Ide, Alyssa D. McNulty, Kristopher M. Attwood, Tessa F. Flores, Allana M. Krolikowski, Kevin T. Robillard and Mary E. Reid
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Kathryn M. Glaser: Department of Cancer Prevention and Populations Science, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Christina R. Crabtree-Ide: Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Alyssa D. McNulty: Department of Cancer Prevention and Populations Science, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Kristopher M. Attwood: Department of Biostatistics & Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Tessa F. Flores: Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Allana M. Krolikowski: Jericho Road Community Health Center, Buffalo, NY 14213, USA
Kevin T. Robillard: Department of Internal Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Mary E. Reid: Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA

IJERPH, 2024, vol. 21, issue 2, 1-12

Abstract: Background: Colorectal cancer (CRC) screening is effective in the prevention and early detection of cancer. Implementing evidence-based screening guidelines remains a challenge, especially in Federally Qualified Health Centers (FQHCs), where current rates (43%) are lower than national goals (80%), and even lower in populations with limited English proficiency (LEP) who experience increased barriers to care related to systemic inequities. Methods: This quality improvement (QI) initiative began in 2016, focused on utilizing patient navigation and practice facilitation to addressing systemic inequities and barriers to care to increase CRC screening rates at an urban FQHC, with two clinical locations (the intervention and control sites) serving a diverse population through culturally tailored education and navigation. Results: Between August 2016 and December 2018, CRC screening rates increased significantly from 31% to 59% at the intervention site ( p < 0.001), with the most notable change in patients with LEP. Since 2018 through December 2022, navigation and practice facilitation expanded to all clinics, and the overall CRC screening rates continued to increase from 43% to 50%, demonstrating the effectiveness of patient navigation to address systemic inequities. Conclusions: This multilevel intervention addressed structural inequities and barriers to care by implementing evidence-based guidelines into practice, and combining patient navigation and practice facilitation to successfully increase the CRC screening rates at this FQHC.

Keywords: patient navigation; practice facilitation; colorectal cancer screening; outreach and education; refugee and immigrant health; limited English proficiency (LEP) (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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