Implementation Research to Increase Colorectal Cancer Screening Rates Among Low Income and Ethnic Minority Groups

Primary outcomes

1. Colorectal cancer (CRC) screening rate

   Time frame: Up to 3 years

   Patient-level study data on the primary outcome of CRC screening receipt will be assessed through electronic health record data systems. Fecal immunochemical test (FIT) is the screening method most commonly utilized in NEVHC. Patients who have completed a FIT within the past 12 months will be considered screened. Consistent with current CRC screening guidelines, patients screened via a flexible sigmoidoscopy in the past five years (very rare) or colonoscopy (very small numbers) in the past ten years will also be considered screened. The data will be analyzed using generalized linear mixed models that account for clustering within clinic and provider and multiple observations within patients.

2. Rate of failure to provide a FIT kit to an eligible patient making a clinic visit

   Time frame: Up to 3 years

   Missed opportunity rates will be calculated at baseline, end of study, and intermediate time points by determining the number of eligible patients who made a clinic visit but did not receive a FIT kit. The data will be analyzed using generalized linear mixed models that account for clustering within clinic and provider and multiple observations within patients.

3. Return rate of completed FIT kits

   Time frame: Up to 3 years

   The data will be analyzed using generalized linear mixed models that account for clustering within clinic and provider and multiple observations within patients.