Increasing Colorectal Cancer Screening in Health Care Systems Using Evidence-Based Interventions

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There are 22 state grantees (Alabama State Department of Health, Arkansas Department of Health, California Department of Public Health, Colorado Department of Public Health and Environment, Delaware Department of Health and Social Services, District of Columbia Department of Health, Florida Department of Health, Idaho Department of Health and Welfare, Iowa Department of Public Health, Kentucky Cabinet for Health and Family Services, Louisiana State University Health Sciences Center, Mary Hitchcock Memorial Hospital [NH], Maryland Department of Health and Mental Hygiene, Massachusetts Department of Public Health, Michigan Department of Community Health, Minnesota Department of Health, Montana Department of Public Health and Human Services, Nevada Division of Public and Behavioral Health, New York State Department of Health, Oregon Health Authority, Rhode Island Department of Health, South Dakota Department of Health), 7 university grantees (University of Chicago, University of Puerto Rico, University of South Carolina, University of Wisconsin, Virginia Department of Health, Washington State Department of Health, West Virginia University), and 1 tribal grantee (Great Plains Tribal Chairmen’s Health Board).

Figure 1.
Map Showing Grantees of CDC’s Colorectal Cancer Control Program, Program Year 1, July 2015 through June 2016. Abbreviation: CDC, Centers for Disease Control and Prevention.

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The CRCCP logic model defines grantee activities that lead to short and intermediate outcomes. To increase health system CRC screening rates, CRCCP grantees conduct several activities. Grantees partner with health systems, clinics, and others. Grantees implement up to 4 priority EBIs including providing patient and provider reminders, giving provider assessment and feedback, and reducing structural barriers. Grantees implement up to 2 SAs, small media and patient navigation. To help connect community members to screening services, grantees facilitate community–clinical linkages through targeted outreach, use community health workers, and link community members to medical homes. Finally, grantees deliver professional development training to health system clinics and provide support for improving information technology, including for electronic health record systems. These activities lead to several short-term outcomes including working partnerships, implemented EBIs and SAs in clinics, screened priority patient populations, improved provider knowledge of CRC screening and quality standards, and health system or clinic data that are used. These short-term outcomes contribute to the intermediate outcome of increased health system/clinic CRC screening rates.

Figure 2.
Program Logic Model Showing Activities and Outcomes of the Colorectal Cancer Control Program, Program Year 1, Centers for Disease Control and Prevention, July 2015 through June 2016. Abbreviations: CRC, colorectal cancer; EBIs, evidence-based interventions; SAs, supporting activities.

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