Strategies and Opportunities to Stop Colon Cancer in Priority Populations

产品说明：联邦政府制定了2020年健康人群的目标，即70.5%的结直肠癌（CRC）筛查率，但几乎一半符合条件的美国成年人没有及时进行筛查。在少数民族和低收入人群中，CRC筛查率极低。为了解决这一差距，我们将开发和测试一个文化定制的，基于医疗保健系统的计划，以提高OCHIN的CRC筛查率，OCHIN是一个由200多个联邦合格卫生中心（FATHCs）组成的社区合作网络。种族和少数民族，沿着低收入和医疗服务不足的人群，越来越多地在美国医疗保健中心接受初级保健，该中心每年为近1900万患者提供服务。OCHIN是最大的全国性FQHC网络。它的综合电子健康记录系统结合了医疗，实验室和索赔数据，将作为我们研究的一个新的和强大的数据源。在第一阶段（2001年），我们将在两个OCHIN中心的CRC筛查中试点测试一种以证据为基础的方法，以提高参与率。这一阶段将包括评估干预的可行性、有效性和成本。在第二阶段（02 - 05年），我们将进行一项比较有效的实用临床试验，使用混合方法的方法来评估我们的CRC筛查计划的采用，实施和维护，该计划明确设计用于CNOHC诊所。在整个项目中，我们将与OCHIN临床医生和患者，社区代表，国家政策制定者和研究人员组成的多元化规划咨询小组合作，采用基于社区的前瞻性研究原则。由于OCHIN是最大的单一CRC网络，为不同种族、民族和保险状况的患者提供服务，我们的研究结果将在加速服务不足人群的CRC筛查研究方面发挥变革性作用。我们的计划将扩大电子健康信息的有意义的使用;协同实现国家目标，以提高癌症筛查率，解决健康差距，并降低医疗保健成本;并作为未来基于系统的方法的催化剂，以改善CNOHC和其他卫生系统的医疗服务。

DESCRIPTION: The federal government has set a Healthy People 2020 goal of a 70.5% screening rate for colorectal cancer (CRC), but almost half of eligible U.S. adults are not up to date on their screenings. Among minority and low-income populations, the CRC screening rate is extremely low. To address this disparity, we will develop and test a culturally tailored, health care system-based program to improve CRC screening rates in OCHIN, a community-based collaborative network of more than 200 Federally Qualified Health Centers (FQHCs). Racial and ethnic minorities, along with low-income and medically underserved populations, increasingly receive their primary care at FQHCs, which serve nearly 19 million patients annually throughout the United States. OCHIN is the largest national FQHC network. Its integrated electronic health record system combining medical, laboratory, and claims data will serve as a novel and robust data source for our study. In Phase I (Year 01), we will pilot-test an evidence-based approach to improving participation in CRC screening in two OCHIN FQHCs. This phase will include an assessment of the intervention s feasibility, effectiveness, and cost. In Phase II (Years 02 05), we will conduct a comparative effectiveness pragmatic clinical trial, using a mixed-methods approach to evaluate the adoption, implementation, and maintenance of our CRC screening program designed explicitly for FQHC clinics. Throughout the project, we will work with a diverse planning advisory group of OCHIN clinicians and patients, community representatives, state policy makers, and researchers, using principles of Community-Based Participatory Research. Because OCHIN is the largest single FQHC network and serves patients who are diverse in race, ethnicity, and insurance status, our results will play a transformative role in accelerating CRC screening research in underserved populations. Our program will expand meaningful use of electronic health information; synergistically meet national goals to improve cancer screening rates, address health disparities, and reduce health care costs; and act as a catalyst for future systems-based approaches to improve care delivery in FQHCs and other health systems.