Implementing an enhanced mailed FIT program to improve CRC screening at a federally qualified health center: experiences of patients and staff.

Autor:	Schneider JL; Science Program Department, Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA., Rivelli JS; Science Program Department, Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA., Vaughn KA; Science Program Department, Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA., Thompson JH; Science Program Department, Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA., Petrik AF; Science Program Department, Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA., Escaron AL; AltaMed Institute for Health Equity, AltaMed Health Services Corporation, 2040 Camfield Avenue, Los Angeles, CA 90040, USA., Coronado GD; Science Program Department, Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR 97227, USA.
Jazyk:	angličtina
Zdroj:	Translational behavioral medicine [Transl Behav Med] 2023 Sep 28; Vol. 13 (10), pp. 757-767.
DOI:	10.1093/tbm/ibad025
Abstrakt:	Colorectal cancer (CRC) is a leading cause of cancer death in the USA. Screening programs in federally qualified health centers (FQHCs) are essential to reducing CRC-related mortality and morbidity among underserved populations. Centralized, population-based mailed fecal immunochemical test (FIT) programs can improve CRC screening rates, but barriers to implementation remain. We qualitatively explored barriers and facilitators to implementation of a mailed FIT program at a large, urban FQHC that employed advance notification "primers" (live calls and texts) and automated reminders. We interviewed 25 patients and 45 FQHC staff by telephone about their experience with the program. Interviews were transcribed, coded, and content analyzed using NVivo.12. Patients and staff found advance notifications conveyed through live phone calls or text messages to be acceptable and motivational for FIT completion. Live phone primers were helpful in addressing patients' questions and misconceptions about screening, particularly for patients new to screening. Advance notifications sent by text were considered timely and useful in preparing patients for receipt of the FIT. Barriers to implementation included lack of receipt of primers, reminders, or the mailed FIT itself due to inaccurate patient contact information within the FQHC medical record; lack of systems for documenting mailed FIT outreach to coordinate with clinical care; and lack of local caller identification for primers and reminders. Our findings demonstrate that an enhanced mailed FIT program using primers and reminders was acceptable. Our findings can help other FQHCs implement and optimize their mailed FIT programs. (© Society of Behavioral Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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