Intervention Type: Reducing structural barriers

Flexible clinic hours, working in non-clinical settings, offering transportation, etc. (Community Guide recommended*)

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Innovative Ways To Increase Colorectal Cancer Screening Among The Underserved – February 20, 2018

This webinar was a repeat of one of our most highly rated workshops from the NCCRT meeting last month. The purpose of the webinar was to move beyond describing the challenges of reaching the underserved to showcasing innovative solutions, including using systems change to increase colorectal cancer screening in a multi-ethnic community; providing an example of how local health departments can team up with academics on community engagement; and partnering with emergency departments to reach rural residents who don’t have a primary care provider.

Speakers:

  • Joseph Ravenell, MD, MS, Assistant Professor of Population Health and Medicine; Associate Dean for Diversity Affairs and Inclusion at NYU School of Medicine; NCCRT Steering Committee (Presenter/Moderator)
  • Karen E. Kim, MD, Professor of Medicine, Dean, Faculty Affairs, Associate Director, Cancer Disparities, the University of Chicago Medicine Comprehensive Cancer Center
  • Jenna Hatcher, RN, PhD, MPH, Director of Diversity and Inclusion, University of Kentucky, College of Nursing
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Additional Q&A

Colorectal Cancer Screening In American Indian & Alaska Native Communities – November 28, 2017

This webinar explored the opportunities and barriers related to delivering quality colorectal cancer screening and follow-up care in health care settings serving American Indian and Alaska Native (AI/AN) communities. The webinar provided a review of basic basic data on colorectal cancer incidence, mortality, and screening rates in AI/AN populations, an overview of the American Cancer Society and the NCCRT’s work to address this issue, and presentations from two AI/AN-serving healthcare systems about their innovative approaches to increasing colorectal cancer screening.

Learn more about the American Cancer Society and the NCCRT’s work to address this issue in the post-meeting report from the April 2016 one-day summit to explore the challenges and potential solutions to improving access to quality colorectal cancer screening in this population.

Speakers:

  • Kris Rhodes, MPH, Chief Executive Officer, American Indian Cancer Foundation (Moderator)
  • Laura Makaroff, DO, Senior Director, Cancer Control Intervention, American Cancer Society, Inc.
  • Jessica Deaton, RN, BSN, Care Manager, Oklahoma City Indian Clinic
  • Richard Mousseau, MS, Director, Community Health Prevention Programs, Great Plains Tribal Chairmen’s Health Board
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best practices handbook for health plans
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“Thank you! This is exactly the type of information health plans need to pass to one another to improve partnership/collaboration, as the consumer will benefit at the end.”

“I really enjoyed that each of the health plans featured in the toolkit highlights a different intervention or opportunity. That gives our partners many approaches to choose from.”

Colorectal Cancer Screening Best Practices Handbook for Health Plans

Health plans have an essential role to play in the effort to screen more Americans for colorectal cancer, particularly given that seven out of 10 people who are unscreened are covered by insurance.

Colorectal Cancer Screening Best Practices Handbook for Health Plans, provides a first-of-its-kind compilation of best practices, case studies, templates and tools, that will kick start or infuse health plans’ efforts to save more lives and prevent more cancers.

To develop the handbook, the NCCRT convened an advisory group of health plan experts and interviewed high-performing health plans to understand what works and what doesn’t when it comes to increasing screening among members. Thank you to the many individuals and organizations who contributed their time and expertise to developing this much requested resource.

In the future, we hope to update this handbook with more case studies from high-performing health plans. If you have a story to share about how your health plan has worked to raise colorectal cancer screening rates, please email nccrt@cancer.org.

NCCRT’s issue brief, The Importance of Waiving Cost-sharing for Follow-up Colonoscopies, provides additional information on the colonoscopy copay issue.

View the March 28, 2017 webinar introducing the Handbook for a guided tour of the best practices, case studies, and templates and tools found within the handbook, and hear from one of the profiled health plans.

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How To Pay For Screening Navigation Toolkit

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How to Pay for Screening Navigation Toolkit – January 10, 2017

This webinar introduced the NCCRT and the Colorado School of Public Health’s new toolkit: Paying for Colorectal Cancer Screening Patient Navigation Toolkit. The toolkit provides practical advice on paying for and sustaining colorectal cancer screening patient navigation. It’s designed to help health care professionals at various stages of establishing a screening navigation program. While there are no magic wand solutions, we are confident you will find this a comprehensive look at how various programs have sustained their work of interest.

Speakers:

  • Andrea (Andi) Dwyer, Colorado School of Public Health
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flu FIT
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FluFIT Program

FluFIT programs increase colorectal cancer screening rates by providing a take home fecal immunochemical test (FIT) to eligible patients when they receive their annual flu shot. Thus, the annual flu shot campaign create an opportunity to reach people who are also due for colorectal screening.

The FluFIT website offers program planning and implementational materials, including staff training, work flows, log sheets, sample reminder letters, and sample telephone call scripts. The site also provides patient educational materials, such as clinic posters, and FIT instructions (both printed materials and videos) in several languages. These materials can help prepare a healthcare team to develop the simple systems needed to implement a FluFIT program and jump start program development.

FluFIT programs have been implemented successfully in a variety of clinical settings. Many FluFIT campaigns are run by nurses, pharmacists, or medical assistants. They can be implemented and sustained with limited resources, are well accepted by patients, and can lead to higher screening rates.

Evaluation: FluFIT is a research-tested program. Visit the Publications section of the website to find research articles and reviews of the FluFIT approach.

Evaluation Assets: The Program Materials section of the website includes a sample FluFIT log sheet and sample FluFIT results tracking sheet.

Permissions: Made publicly available online by the Department of Family and Community Medicine, University of California.

Publication date: 2009; updated in 2017

Post date: September 15, 2017

Contact: Send comments, questions, and suggestions to Michael Potter, MD at potterm@fcm.ucsf.edu.

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CDC replication manual
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New Hampshire Colorectal Cancer Screening Program Patient Navigation Model Replication Manual

The New Hampshire Colorectal Cancer Screening Program (NHCRCSP) patient navigation model has been highly effective in increasing the completion and quality of colonoscopy screening and surveillance among statewide underserved groups. Patients in this program, all of whom were navigated, were 11 times more likely to complete colonoscopy than non-navigated patients in a comparison group. Given this success, the Centers for Disease Control and Prevention (CDC) and the NHCRCSP worked together to develop a manual to help others replicate the model. The manual includes step-by-step instructions for implementing a screening navigation program, including a detailed navigation protocol, guidance on data collection, navigator training, and sample templates and tools.

Intended Audiences: Any organization that conducts colorectal cancer screening or administers a colonoscopy program may benefit from implementing this intervention. Organizations could include health systems, endoscopy centers, primary care practices (including Federally Qualified Health Centers), universities, state or local health departments, and grantee programs. This manual also may be useful for health care providers, pharmacy staff, and other community partners to clarify their roles in the intervention and how it benefits their patients.

Congratulations to former NCCRT Steering Committee member Dr. Lynn Butterly and to all the others who helped create this resource.

Evaluation: A rigorous evaluation was conducted, including a comparison of NHCRCSP-navigated patients to a similar group of non-navigated patients. Learn more on page 8 and in Appendix D. Evaluation results were also published in the journal Cancer.

Permissions: Made publicly available online through the Centers for Disease Control and Prevention.

Publication date: October 2016

Post date: September 18, 2017

Contact: Send comments, questions, and suggestions to NHPNManual@cdc.gov or NHCRCSP@hitchcock.org.

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Gastroenterologists and Endoscoposts brief
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What Can Gastroenterologists & Endoscopists Do To Advance 80% By 2018?

Learn how gastroenterologists and endoscopists can be part of the national effort to make sure 80% of adults ages 50 and older are regularly screened for colorectal cancer by 2018.

Review the supplement to this brief, Identifying High Risk Patients and Families in Your Practice, for guidance on steps you can take to ensure your patients and their families receive timely and appropriate screening.

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NYS Department of Health
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Paid Leave Policies for Cancer Screenings

The New York State Department of Health offers resources to help employers develop an effective policy of providing paid leave for employee colorectal cancer screenings (breast and cervical are also covered).

The resources make the case for employers that by providing paid leave for cancer screenings, employers may realize a healthier workforce and be able to reduce expenses on worker compensation and disability costs, replacement costs for ill or injured employees who are absent, and recruitment and training costs for new employees. The website also walks employers through elements of an effective policy on paid leave, such as including union leadership in the process considering Employment Retirement Income and Security Act (ERISA) requirements.

Thank you to NCCRT Steering Committee member Dr. Heather Dacus for sharing these resources.

Evaluation: The content and messaging was developed based on information gathered from literature searches and from feedback from contractors implementing paid leave about common barriers they encountered when promoting the work.

Permissions: Made publicly available online through the New York State Department of Health.

Publication date: May 2016

Post date: September 20, 2017

Contact: Email comments, questions, and suggestions to CanServ@health.ny.gov.

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introductory packet
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What Can Comprehensive Cancer Control Coalitions Do To Advance 80% By 2018?

Learn how CCC coalitions can be part of the national effort to make sure 80% of adults ages 50 and older are regularly screened for colorectal cancer by 2018.

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  • medicaid expansion

Study on Medicaid Expansion and Access

A study released by the American Cancer Society Cancer Action Network (ACS CAN) and the NCCRT estimates that in 2017 over 2.7 million low-income men and women aged 50-64 will remain uninsured and continue to lack access to an affordable health care coverage option, including colorectal cancer screening services.

The report, Health Reform and the Implications for Cancer Screening, provides national and state-specific estimates of the number of uninsured men and women in 2017 based on three scenarios: Medicaid expansion decisions as of April 2015, no state Medicaid expansions, and if all states expand Medicaid. Read the ACS CAN report summary.

Many thanks to our partners at ACS CAN for developing the report, and to NCCRT’s Policy Action Task Group members Barry Berger, Joel Brill, Heather Dacus and Holly Wolf for generously sharing their expertise in the review process.