Adoption and Implementation of Evidence-Based Colorectal Cancer Screening Interventions Among Cancer Control Program Grantees, 2009-2015
Adoption and Implementation of Evidence-Based Colorectal Cancer Screening Interventions Among Cancer Control Program Grantees, 2009-2015
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DOI：
10.5888/pcd16.180682
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发表时间：
2019-10-01
影响因子：
5.5
通讯作者：
Degroff, Amy
中科院分区：
文献类型：
--
作者：
Hannon, Peggy A.;Maxwell, Annette E.;Degroff, Amy
目的和目的结直肠癌(CRC)是美国第二大癌症死亡原因。虽然存在有效的CRC筛查测试，但CRC筛查未得到充分利用。使用循证干预(EBI)来增加结直肠癌筛查可以挽救许多人的生命。疾病控制和预防中心(CDC)的结直肠癌控制计划(CRCCP)为研究EBI的采用、实施和维护提供了一个独特的机会。我们评估了1)2011至2015年间实施5个EBI的受赠者数量，2)受赠者对实施每个EBI的感受，以及3)受赠者停止实施EBI的原因。干预方法CDC资助25个州和4个部落实体参与CRCCP。受赠人利用CRCCP资金1)向未参保和低收入的个人提供CRC筛查，以及2)在人口层面促进CRC筛查。CRC筛查宣传工作的一个组成部分是实施5个EBI中的1个或更多以提高CRC筛查率。评估方法我们在2011年、2012年、2013年和2015年通过在线调查对CRCCP受赠者进行了EBI实施情况的调查。我们对封闭式项目进行了描述性分析，并对与EBI实施的障碍和促进者相关的主题进行了编码开放文本回复。结果大多数受赠者实施了小型媒体(=25)或客户提醒(=21)，或在所有计划年都实施了这两种方式。虽然很少有受赠人报告在2011年实施了EBI，例如减少结构障碍(n=14)和提醒提供者(n=9)，但随着时间的推移，这些EBI的执行情况有所增加。随着时间的推移，提供者评估和反馈的执行情况有所增加，但2015年报告的受赠者最少(n=17)。终止EBI的原因包括资金终止、优先事项竞争或工作人员能力有限。对公共卫生的影响CRCCP受赠者在研究的所有年份都实施了EBI，但实施情况因EBI而异，并且不会随着时间的推移而变得更容易。我们的发现可以为州和部落公共卫生机构及其合作伙伴制定EBI的长期规划提供信息。
Purpose and ObjectivesColorectal cancer (CRC) is the second-leading cause of cancer death in the United States. Although effective CRC screening tests exist, CRC screening is underused. Use of evidence-based interventions (EBIs) to increase CRC screening could save many lives. The Colorectal Cancer Control Program (CRCCP) of the Centers for Disease Control and Prevention (CDC) provides a unique opportunity to study EBI adoption, implementation, and maintenance. We assessed 1) the number of grantees implementing 5 EBIs during 2011 through 2015, 2) grantees' perceived ease of implementing each EBI, and 3) grantees' reasons for stopping EBI implementation.Intervention ApproachCDC funded 25 states and 4 tribal entities to participate in the CRCCP. Grantees used CRCCP funds to 1) provide CRC screening to individuals who were uninsured and low-income, and 2) promote CRC screening at the population level. One component of the CRC screening promotion effort was implementing 1 or more of 5 EBIs to increase CRC screening rates.Evaluation MethodsWe surveyed CRCCP grantees about EBI implementation with an online survey in 2011, 2012, 2013, and 2015. We conducted descriptive analyses of closed-ended items and coded open-text responses for themes related to barriers and facilitators to EBI implementation.ResultsMost grantees implemented small media (>= 25) or client reminders (>= 21) or both all program years. Although few grantees reported implementation of EBIs such as reducing structural barriers (n = 14) and provider reminders (n = 9) in 2011, implementation of these EBIs increased over time. Implementation of provider assessment and feedback increased over time, but was reported by the fewest grantees (n = 17) in 2015. Reasons for discontinuing EBIs included funding ending, competing priorities, or limited staff capacity.Implications for Public HealthCRCCP grantees implemented EBIs across all years studied, yet implementation varied by EBI and did not get easier with time. Our findings can inform long-term planning for EBIs with state and tribal public health institutions and their partners.