title: Fostering partnerships and program success.
abstract: BACKGROUND
  Fostering partnerships was critical to the success of the Colon Health Program (CHP) in Greater Seattle. The CHP was built on the Breast and Cervical Health Program (BCHP) framework. A replicable system to provide quality colorectal screening services for individuals with limited incomes and no health insurance was developed.
  
  
  METHODS
  Partners were recruited and engaged during 3 programmatic phases: 1) development and start-up, 2) implementation, and 3) sustainability planning. Several tactics were used to develop trust and build bridges among the partners and to create an effective work group.
  
  
  RESULTS
  The partners were critical to developing clinic policies, procedures, and systems to increase colorectal screening and improve follow-up; expanding access to colonoscopies; and initiating statewide dissemination of training and systems as well as policy change. The fecal occult blood test completion rate was 61%, and the colonoscopy completion rate was 78%. The colonoscopy navigation system was effective with a low "no show" rate (8%). The partners were instrumental in helping Washington State obtain funding from the Centers for Disease Control and Prevention to continue the CHP statewide.
  
  
  CONCLUSIONS
  During implementation, key elements for success included: building the project on the successful BCHP framework, meticulous training of clinic staff about colorectal cancer and screening methods, frequent consultation to identify and solve problems, active support of the clinic administration, and the presence of a CHP champion in the clinic. Institutionalization of the CHP depended on: assessing progress after the first year, documenting experience with the program, disseminating lessons learned, engaging new partners, and determining steps to expand the program.
authors.affiliation: Public Health, Seattle & King County, Seattle, Washington 98104, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Phillips-Angeles
authors.forename: Lin
authors.initials: L
authors.lastname: Song
authors.forename: Peggy A
authors.initials: PA
authors.lastname: Hannon
authors.forename: Megan
authors.initials: M
authors.lastname: Celedonia
authors.forename: Steven
authors.initials: S
authors.lastname: Stearns
authors.forename: Kris
authors.initials: K
authors.lastname: Edwards
authors.forename: Scott
authors.initials: S
authors.lastname: Feest
authors.forename: Amy
authors.initials: A
authors.lastname: Shumann
mesh_terms: D000368:Aged; D002487:Centers for Disease Control and Prevention, U.S.; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control*; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D008875:Middle Aged; D011203:Poverty; D014481:United States
keywords: clinic policies, procedures, and systems to increase screening and assure follow-up; colorectal cancer; expand access to colonoscopies; partnerships; program dissemination