2011 CRCCP Grantee Survey of Program Implementation CRCCP

2011 CRCCP Grantee Survey of Program Implementation CRCCP

2011 CRCCP Grantee Survey of Program Implementation CRCCP Cross Center Workgroup CRCCP Committee Members CPCRN Peggy Hannon Jennifer Allen Andrea Dwyer Michelle Carvalho

Cam Escoffery James Hebert Matt Kreuter Annette Maxwell Cathy Melvin Sandra Morones Debbie Pfeiffer Sally Vernon Thuy Vu Rebecca Williams And others! CDC Amy DeGroff Vicki Bernard Kathi Wilson And others! Colorectal Cancer

Cancer of the colon or rectum is the second leading cause of cancer-related deaths in the United States Screening Finds precancerous polyps (abnormal growths in the colon or rectum) so that they can be removed before turning into cancer. Detects colorectal cancer at an early stage, when treatment often leads to a cure. About 9 / 10 people whose colorectal cancer is found early and treated are still alive five years later CDC's Colorectal Cancer Control Program (CRCCP) Goal: to increase colorectal (colon) cancer

screening rates among men and women aged 50 years and older from about 64%1 to 80% in the funded states by 2014 Program has two components: screening promotion and screening provision CRCCP Grantees 5/25/2010 CDCs Colorectal Cancer Control Program:Simplified Logic Model State and Tribal Grantees, in Collaboration with CCC Coalitions and Other Partners, Conduct These Activities To Create These Changes that Improve or Increase Provider Practices that Promote High Quality CRC

Screening Policy-Level Influence Policy/Legislation Community-Level Increase General Population Awareness Organizational-Level Influence Health Care Systems, Insurers, Workplaces, CBOs, Professional Organizations Individual-Level Provide and/or Facilitate Screening for Medically Underserved In Order to Achieve Population-Level Program Outcomes Increased CRC Prevention via Polypectomy Policies &

Systems that Promote CRC Screening Population and Provider Knowledge, Attitudes, & Intentions about CRC Screening Social Norms that Support CRC Screening Proportion of Adults Seeking CRC Screening as Recommended Program Monitoring and Evaluation Increased, Appropriate CRC

Screening Increased Detection of Early Stage CRC Decreased Disparities in CRC Screening and Detection CRCCP Workgroup A unique opportunity for CPCRN Natural laboratory for dissemination Defined set of cancer control EBIs Large-scale practice settings Perfect timing Overall Workgroup Goals CRCCP workgroup will implement the Annual Grantee Survey, 2011-2014 CRCCP workgroup will develop and implement additional research projects to assess details of

Adoption Implementation Context Technical support and Resources needed/available Organizational Characteristics Annual Grantee Survey Goals 1. Understand how grantees are implementing CDCs Colorectal Cancer Control Program (CRCCP), 2. Establish a baseline to assess how implementation changes each year, and 3. Collect information related to technical assistance and training needs.

Methods Audience: person responsible for day-to-day management of the CRCCP should complete this survey Sample: 29 programs (25 states and 4 tribes) across the U.S. Design: Cross-sectional online survey (Qualtrics) over 4 years Sections of the Grantee Survey CRCCP Management and Integration with Other Programs Adoption and implementation of 5 Guide EBIs and

patient navigation CRC Screening Provision CRC Screening Promotion CRC Screening Data from FQHCs, IHS Clinics, etc. Screening Policies & Strategies Training and Technical Assistance for EvidenceBased Interventions General Program Management (i.e. Monitoring & Evaluation, Administrative Issues) Respondent characteristics D&I Frameworks Guiding Survey Topics

Conceptual Model RE-AIM with focus on Adoption, Implementation and Maintenance of 5 Community Guide evidence-based strategies Client reminders Small media Reduce structural barriers Provider reminders Provide provider assessment and feedback Interactive Systems Framework for Dissemination and Implementation (ISF) Prevention Support System (training and technical assistance)

Implementation Research Questions Adoption Topics Which of the 5 evidence-based strategies do the grantees adopt? How do the grantees translate the evidence-based strategies into interventions? What are these sources of interventions? What resources does it take? Implementation Topics

Which of the 5 strategies do the grantees implement? What implementation barriers and facilitators do grantees encounter for each of the strategies they implement? What type of training or technical assistance do they receive or provide to their contractors in using evidence? Maintenance What strategies are consistently adopted over time? Implementation Research Questions Construct Conceptua l Framewor k Sample Questions Adoption RE-AIM Does your organization use [small

media] to promote colorectal cancer screening? Adoption Facilitators RE-AIM What are the top reasons your organizations chose to use [small media] to promote CRC screening? Implementatio n RE-AIM Please indicate where your organization uses each of the small media types listed in the table below, to promote CRC screening (e.g., video, flyers/posters, brochures, newsletters) Implementatio n Ease

RE-AIM Thinking about the evidence-based interventions (EBI) that your organization implements currently, rate the following EBIs by the level of Implementation Research Questions Construct Conceptua l Framewor k Sample Questions Implementatio n Barrier RE-AIM For the evidence-based strategies that were the most difficult to implement, what made it difficult?

Implementatio n Facilitator RE-AIM For the evidence-based strategies that were the easiest to implement, what made it easy? Training needs ISF for use of Training evidence and Technical Assistance Rate your desire for training in the following areas (e.g., find EBI, adapt a strategy) For which of the evidence-based strategies would you like to receive more training or technical assistance? Technical assistance

Do you have access to someone who can help you interpret and apply ISF Technical Survey Next Steps Approvals for all IRBs (+ CDC) are in!! Finalize survey administration in Qualtrics Pilot-test survey Administration in October/November 2011 Breakout Discussion Topics

Initial survey administration ideas Case studies with high and low-implementing grantees Assessing quality of what they implement Surveying/interviewing grantees implementation partners Offering training or other resources to meet grantees needs Examining registry data More with MIYO How can our data inform: Future D&I projects CRCCP program improvement 2011-2012 Workplan Grantee survey

1st administration November 2011 Analysis December 2011-February 2012 Report back to grantees & CDC Submit abstract to CDC Cancer Conference Revise survey for 2012 2nd administration July 2012 2011-2012 Workplan, continued Case studies with high and low-implementers

Identify cases & topics February 2012 Design case study methods February-March 2012 Conduct case studies/interviews April-May 2012 Analyze findings June-July 2012 Write paper(s)/abstracts July-September 2012 Develop workplan/research questions for 2012-2013 Questions Peggy Hannon Cam Escoffery Annette Maxwell [email protected] [email protected] [email protected]

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