Implementing mailed FIT and patient navigation in rural settings: Preliminary qualitative findings from the SMARTER CRC study
Presenter Biography
I am second year MPH Health Promotion student & I am a Practice Facilitator at the Oregon Rural Practice-based Research Network at OHSU.
Institution
OHSU
Program/Major
Health Promotion
Degree
MPH
Presentation Type
Poster
Start Date
4-4-2023 2:00 PM
End Date
4-4-2023 3:00 PM
Persistent Identifier
https://archives.pdx.edu/ds/psu/40218
Keywords
Qualitative, Rural, Colorectal Cancer, Screening, Mailed FIT, Patient Navigation
Abstract
Despite the existence of multiple colorectal cancer (CRC) screening methods, disparities persist in rural communities when compared to their urban counterparts. SMARTER CRC is a pragmatic trial aiming to increase CRC screening for rural Medicaid enrollees through a multi-level partnered (i.e., health plans, clinical practices, and vendors) mailed fecal immunochemical test (FIT) outreach and patient navigation program. The SMARTER CRC Qualitative Team aims to identify multi-level factors that are associated with reach, effectiveness, implementation and maintenance and to assess adaptations. Between January 2021 and April 2022 – we conducted 16 organizational interviews; 8 practice facilitator reflections; 5 patient navigator interviews; and 8 health plan-clinic meetings. The contact logs consisted of 14 clinic management forms, 15 clinic intake surveys, 28 workflow assessments, 44 scheduled facilitation field notes, and 170 communication logs. Participants included staff from 3 health plans, 14 rural primary care clinics, and 3 practice facilitators who supported data collection. The research team began with a preliminary template analysis to create memos for each clinic and health plan. The memos track high-level findings specific to context, intervention implementation, and adaptations. After preliminary analyses, the qualitative research team coded the remaining qualitative data and further analyzed the context, implementation, and adaptions queries to triangulate the interview data with the periodic reflections and clinic contact logs. The preliminary qualitative findings highlight the value of multi-level partnerships, practice facilitation, and building community through shared learning experiences. These qualitative findings could inform future CRC screening programs for rural communities and health organizations.
Implementing mailed FIT and patient navigation in rural settings: Preliminary qualitative findings from the SMARTER CRC study
Despite the existence of multiple colorectal cancer (CRC) screening methods, disparities persist in rural communities when compared to their urban counterparts. SMARTER CRC is a pragmatic trial aiming to increase CRC screening for rural Medicaid enrollees through a multi-level partnered (i.e., health plans, clinical practices, and vendors) mailed fecal immunochemical test (FIT) outreach and patient navigation program. The SMARTER CRC Qualitative Team aims to identify multi-level factors that are associated with reach, effectiveness, implementation and maintenance and to assess adaptations. Between January 2021 and April 2022 – we conducted 16 organizational interviews; 8 practice facilitator reflections; 5 patient navigator interviews; and 8 health plan-clinic meetings. The contact logs consisted of 14 clinic management forms, 15 clinic intake surveys, 28 workflow assessments, 44 scheduled facilitation field notes, and 170 communication logs. Participants included staff from 3 health plans, 14 rural primary care clinics, and 3 practice facilitators who supported data collection. The research team began with a preliminary template analysis to create memos for each clinic and health plan. The memos track high-level findings specific to context, intervention implementation, and adaptations. After preliminary analyses, the qualitative research team coded the remaining qualitative data and further analyzed the context, implementation, and adaptions queries to triangulate the interview data with the periodic reflections and clinic contact logs. The preliminary qualitative findings highlight the value of multi-level partnerships, practice facilitation, and building community through shared learning experiences. These qualitative findings could inform future CRC screening programs for rural communities and health organizations.