Evaluating a remotely delivered, digital health CRC screening intervention among racially diverse patients of a community health center

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Project Summary/Abstract Colorectal cancer (CRC) screening is one of the most effective tools to reduce cancer morbidity and mortality. Yet, CRC screening rates at federally qualified health centers (FQHCs) in rural areas lag behind more well- resourced healthcare systems and national goals. Improving CRC screening in rural FQHCs requires attention to the needs of their patient populations as well as their limited resources for implementation; yet, little research has tested CRC screening programs with FQHCs that are culturally responsive, contextually relevant and alleviate implementation burden. Our long-term goal is to scale implementation of CRC screening solutions that will reduce inequities that burden FQHCs. Our team has developed a novel digital health platform, mPATH-Cloud, that has the potential to help alleviate implementation burden on clinical teams by automating many key processes, all the while delivering CRC screening communication, education, and services in ways that have proven to be culturally responsive, patient-centered, and effective. Thus, our study seeks to evaluate mPATH-Cloud with rural FQHCs to demonstrate effectiveness at improving guideline concordant screening and identify critical implementation processes and outcomes that will impact future dissemination and scalability. We will use an embedded experimental mixed methods model, which includes an individual randomized trial of the multi-component intervention, quantitative and qualitative measures to identify ways to improve tailored messaging and adapt strategies to improve effectiveness across diverse patient profiles, and quantitative and qualitative measures of processes and outcomes to improve implementation. Our team is well-situated to lead this research, which if successful, will lead to progress toward reducing inequities in low-income rural communities served by FQHCs.