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.
Implementing the CDC's Colorectal Cancer Screening Demonstration Program: Wisdom from the field
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 2870–2883, 1 August 2013
How to Cite
Rohan, E. A., Boehm, J. E., DeGroff, A., Glover-Kudon, R. and Preissle, J. (2013), Implementing the CDC's Colorectal Cancer Screening Demonstration Program: Wisdom from the field. Cancer, 119: 2870–2883. doi: 10.1002/cncr.28162
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.
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
- Issue published online: 18 JUL 2013
- Article first published online: 18 JUL 2013
- Manuscript Accepted: 18 OCT 2012
- Manuscript Revised: 24 SEP 2012
- Manuscript Received: 11 JUL 2012
- colorectal cancer screening;
- program evaluation;
- qualitative evaluation;
- interdisciplinary communication;
- early detection of cancer;
- cancer screening tests;
- program implementation
Colorectal cancer, as the second leading cause of cancer-related deaths among men and women in the United States, represents an important area for public health intervention. Although colorectal cancer screening can prevent cancer and detect disease early when treatment is most effective, few organized public health screening programs have been implemented and evaluated. From 2005 to 2009, the Centers for Disease Control and Prevention funded 5 sites to participate in the Colorectal Cancer Screening Demonstration Program (CRCSDP), which was designed to reach medically underserved populations.
The authors conducted a longitudinal, multiple case study to analyze program implementation processes. Qualitative methods included interviews with 100 stakeholders, 125 observations, and review of 19 documents. Data were analyzed within and across cases.
Several themes related to CRCSDP implementation emerged from the cross-case analysis: the complexity of colorectal cancer screening, the need for teamwork and collaboration, integration of the program into existing systems, the ability of programs to use wisdom at the local level, and the influence of social norms. Although these themes were explored independently from 1 another, interaction across themes was evident.
Colorectal cancer screening is clinically complex, and its screening methods are not well accepted by the general public; both of these circumstances have implications for program implementation. Using patient navigation, engaging in transdisciplinary teamwork, assimilating new programs into existing clinical settings, and deferring to local-level wisdom together helped to address complexity and enhance program implementation. In addition, public health efforts must confront negative social norms around colorectal cancer screening. Cancer 2013;119(15 suppl):2870–83. © 2013 American Cancer Society.