title: A Process Evaluation of the Alaska Native Colorectal Cancer Family Outreach Program.
abstract: This article presents the results of a process evaluation of the Alaska Native (AN) Colorectal Cancer (CRC) Family Outreach Program, which encourages CRC screening among AN first-degree relatives (i.e., parents, siblings, adult children; hereafter referred to as relatives) of CRC patients. Among AN people incidence and death rates from CRC are the highest of any ethnic/racial group in the United States. Relatives of CRC patients are at increased risk; however, CRC can be prevented and detected early through screening. The evaluation included key informant interviews (August to November 2012) with AN and non-AN stakeholders and program document review. Five key process evaluation components were identified: program formation, evolution, outreach responses, strengths, and barriers and challenges. Key themes included an incremental approach that led to a fully formed program and the need for dedicated, culturally competent patient navigation. Challenges included differing relatives' responses to screening outreach, health system data access and coordination, and the program impact of reliance on grant funding. This program evaluation indicated a need for more research into motivating patient screening behaviors, electronic medical records systems quality improvement projects, improved data-sharing protocols, and program sustainability planning to continue the dedicated efforts to promote screening in this increased risk population.
authors.affiliation: Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA dredwood@anthc.org.
authors.forename: Diana
authors.initials: D
authors.lastname: Redwood
authors.affiliation: Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Provost
authors.affiliation: University of Alaska Fairbanks, AK, USA.
authors.forename: Ellen D S
authors.initials: ED
authors.lastname: Lopez
authors.affiliation: Montana State University, Bozeman, MT, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Skewes
authors.affiliation: University of Alaska Anchorage, AK, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Johnson
authors.affiliation: Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Christensen
authors.affiliation: Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Sacco
authors.affiliation: Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Albuquerque, NM, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Haverkamp
mesh_terms: D000328:Adult; D000413:Alaska; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D005190:Family; D006303:Health Services, Indigenous; D006801:Humans; D004930:Inuit; D008403:Mass Screening; D008913:Minority Groups; D062526:Patient Navigation; D015397:Program Evaluation
keywords: Alaska Native people; colorectal cancer prevention; colorectal cancer screening; data-sharing protocols; family history; patient navigators; program sustainability