title: Implementing colorectal cancer screening in community health centers: addressing cancer health disparities through a regional cancer collaborative.
abstract: BACKGROUND
  The population served by Federally Qualified Health Centers (FQHCs) has lower levels of cancer screening compared with the general population and suffers a disproportionate cancer burden. To address these disparities, 3 federal agencies and a primary care association established and tested the feasibility of a Regional Cancer Collaborative (RCC) in 2005.
  
  
  METHODS
  RCC faculty implemented a learning model to improve cancer screening across 4 FQHCs that met explicit organizational readiness criteria. Regional faculty trained "care process leaders," who worked with primary care teams to plan and implement practice changes. FQHCs monitored progress across the following measures of screening implementation: self-management goal-setting; number and percent screened for breast, cervical, and colorectal cancer; percent timely results notification; and percent abnormal screens evaluated within 90 days. Progress and plans were reviewed in regular teleconferences. FQHCs were encouraged to create local communities of practice (LCOP) involving community resources to support cancer screening and to participate in a monthly teleconference that linked the LCOPs into a regional community of practice. Summary reports and administrative data facilitated a process evaluation of the RCC. chi test and test of trends compared baseline and follow-up screening rates.
  
  
  RESULTS
  The RCC taught the collaborative process using process leader training, teleconferences, 2 regional meetings, and local process improvement efforts. All organizations created clinical tracking capabilities and 3 of the 4 established LCOPs, which met monthly in an regional community of practice. Screening documentation increased for all 3 cancers from 2005 to 2007. Colorectal cancer screening increased from 8.6% to 21.2%.
  
  
  CONCLUSIONS
  A regional plan to enable collaborative learning for cancer screening implementation is feasible, and improvements in screening rates can occur among carefully selected organizations.
authors: National Cancer Institute, Bethesda, Maryland, USA. taplins@mail.nih.gov
authors: Stephen H
authors: SH
authors: Taplin
authors: David
authors: D
authors: Haggstrom
authors: Tracy
authors: T
authors: Jacobs
authors: Ada
authors: A
authors: Determan
authors: Jennifer
authors: J
authors: Granger
authors: Wanda
authors: W
authors: Montalvo
authors: William M
authors: WM
authors: Snyder
authors: Susan
authors: S
authors: Lockhart
authors: Ahmed
authors: A
authors: Calvo
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D003159:Community-Institutional Relations; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000458:organization & administration; D011314:Preventive Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D017064:Process Assessment, Health Care; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D012041:Regional Medical Programs / Q000458:organization & administration*; D014481:United States