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Principal Investigator: Leah M. Frerichs
Organization: UNIV OF NORTH CAROLINA CHAPEL HILL
Fiscal Year: 2024
Award: $577,297
Funding agency: National Cancer Institute
Project Summary/Abstract
Colorectal cancer (CRC) screening is one of the most effective tools to reduce cancer morbidity and mortality.
Yet, CRC screening rates at federally qualified health centers (FQHCs) in rural areas lag behind more well-
resourced healthcare systems and national goals. Improving CRC screening in rural FQHCs requires attention
to the needs of their patient populations as well as their limited resources for implementation; yet, little
research has tested CRC screening programs with FQHCs that are culturally responsive, contextually relevant
and alleviate implementation burden. Our long-term goal is to scale implementation of CRC screening
solutions that will reduce inequities that burden FQHCs. Our team has developed a novel digital health
platform, mPATH-Cloud, that has the potential to help alleviate implementation burden on clinical teams by
automating many key processes, all the while delivering CRC screening communication, education, and
services in ways that have proven to be culturally responsive, patient-centered, and effective. Thus, our study
seeks to evaluate mPATH-Cloud with rural FQHCs to demonstrate effectiveness at improving guideline
concordant screening and identify critical implementation processes and outcomes that will impact future
dissemination and scalability. We will use an embedded experimental mixed methods model, which includes
an individual randomized trial of the multi-component intervention, quantitative and qualitative measures to
identify ways to improve tailored messaging and adapt strategies to improve effectiveness across diverse
patient profiles, and quantitative and qualitative measures of processes and outcomes to improve
implementation. Our team is well-situated to lead this research, which if successful, will lead to progress
toward reducing inequities in low-income rural communities served by FQHCs.
Terms: <Address><Affect><Age><American><American Indian><American Indians><Appointment><Assess implementation><Attention><BIPOC><Black><Black race><Black, Indigenous, People of Color><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><CRC screening><Cancer Cause><Cancer Etiology><Cancers><Caring><Cessation of life><Clinic><Clinical><Colonoscopy><Colorectal Cancer><Communication><Community Health Centers><Death><Decision Aid><Disparities><Disparity><Dissemination and Implementation><Education><Educational aspects><Effectiveness><Face><Feces><Federally Qualified Health Center><Friends><Future><Geographic Area><Geographic Locations><Geographic Region><Geographical Location><Goals><Guidelines><Health Care Systems><Health Resources><Health system><Healthcare Systems><Hispanic><Implementation assessment><Individual><Inequity><Intervention><Intervention Strategies><Interview><Knowledge><Lead><Linguistic><Linguistics><Low income><Mail Order><Malignant Neoplasms><Malignant Tumor><Marketing><Measures><Methods><Modeling><Morbidity><Morbidity - disease rate><Neighborhood Health Center><North Carolina><Outcome><Outcome and Process Assessment><Patients><Pb element><Persons><Population Heterogeneity><Preventative service><Preventive service><Primary Care><Process><Process Measure><Provider><Race><Races><Randomization trial><Randomized><Recommendation><Research><Research Resources><Resources><Rural><Rural Community><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Services><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Structural Racism><Subgroup><Technology><Testing><Translating><United States><Visit><Work><ages><assess effectiveness><care as usual><colorectal cancer detection><colorectal cancer early detection><colorectal cancer screening><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><delivered remotely><demographics><detect colorectal cancer><determine effectiveness><digital health><diverse populations><effectiveness assessment><effectiveness evaluation><effectiveness/implementation design><effectiveness/implementation hybrid design><evaluate effectiveness><evaluate implementation><evaluation of implementation><evidence base><examine effectiveness><faces><facial><future implementation><geographic site><heavy metal Pb><heavy metal lead><heterogeneous population><implementation evaluation><implementation outcomes><implementation process><improved><innovate><innovation><innovative><interest><interventional strategy><malignancy><marginalization><member><mortality><multi-component intervention><multi-faceted intervention><multi-modal intervention><multicomponent intervention><multifaceted intervention><multimodal intervention><neoplasm/cancer><new technology><novel><novel technologies><outreach><patient centered><patient oriented><patient population><patient profile><patient subclass><patient subcluster><patient subgroups><patient subpopulations><patient subsets><patient subtypes><population diversity><profiles in patients><racial><racial background><racial diversity><racial origin><racially diverse><randomisation><randomization><randomized trial><randomly assigned><remote care><remote delivery><remote health care><remote healthcare><response><rural area><rural location><rural region><screening><screening program><screenings><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><socio-economic><socio-economically><socioeconomically><socioeconomics><stool><tailored messaging><tool><treatment as usual><usual care>