The articles in this supplement were commissioned based on participation in evaluating the Centers for Disease Control and Prevention–funded Colorectal Cancer Screening Demonstration Program.
Recruiting patients into the CDC's Colorectal Cancer Screening Demonstration Program
Strategies and challenges across 5 sites
Article first published online: 18 JUL 2013
© 2013 American Cancer Society
Special Issue: Comprehensive Evaluation of the Centers for Disease Control and Prevention's Colorectal Cancer Screening Demonstration Program, Supplement to Cancer
Volume 119, Issue Supplement S15, pages 2914–2925, 1 August 2013
How to Cite
Boehm, J. E., Rohan, E. A., Preissle, J., DeGroff, A. and Glover-Kudon, R. (2013), Recruiting patients into the CDC's Colorectal Cancer Screening Demonstration Program. Cancer, 119: 2914–2925. doi: 10.1002/cncr.28161
The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the journal editors, the American Cancer Society, John Wiley & Sons, Inc., or the Centers for Disease Control and Prevention.
Participants in the case study evaluation provided verbal, informed consent for participation in interviews.
- Issue published online: 18 JUL 2013
- Article first published online: 18 JUL 2013
- Manuscript Accepted: 5 NOV 2012
- Manuscript Revised: 5 OCT 2012
- Manuscript Received: 11 JUL 2012
- colorectal cancer screening;
- program evaluation;
- qualitative evaluation;
- program implementation;
- patient recruitment
In 2005, the Centers for Disease Control and Prevention (CDC) funded 5 sites as part of the Colorectal Cancer Screening Demonstration Program (CRCSDP) to provide colorectal cancer screening to low-income, uninsured, and underinsured individuals. Funded sites experienced unexpected challenges in recruiting patients for services.
The authors conducted a longitudinal, qualitative case study of all 5 sites to document program implementation, including recruitment. Data were collected during 3 periods over the 4-year program and included interviews, document review, and observations. After coding and analyzing the data, themes were identified and triangulated across the research team. Patterns were confirmed through member checking, further validating the analytic interpretation.
During early implementation, patient enrollment was low at 4 of the 5 CRCSDP sites. Evaluators found 3 primary challenges to patient recruitment: overreliance on in-reach to National Breast and Cervical Cancer Early Detection Program patients, difficulty keeping colorectal cancer screening and the program a priority among staff at partnering primary care clinics responsible for patient recruitment, and a lack of public knowledge about the need for colorectal cancer screening among patients. To address these challenges, site staff expanded partnerships with additional primary care networks for greater reach, enhanced technical support to primary care providers to ensure more consistent patient enrollment, and developed tailored outreach and education.
Removing financial barriers to colorectal cancer screening was necessary but not sufficient to reach the priority population. To optimize colorectal cancer screening, public health practitioners must work closely with the health care sector to implement evidence-based, comprehensive strategies across individual, environmental, and systems levels of society. Cancer 2013;119(15 suppl):2914–25. © 2013 American Cancer Society.