Initiating Colorectal Cancer Screening in Unscreened Individuals 45 and Over

PRIMARY OBJECTIVES:

I. Identify system-level determinants of colorectal cancer screening in individuals using mixed methods.

II. Identify patient- and system-level determinants of diagnostic colonoscopy after positive fecal immunochemical testing (FIT) test in individuals using mixed methods.

III. Identify equity-driven implementation strategies to initiate colorectal cancer screening and follow-up matched to patient and systems-level determinants.

IV. Determine the acceptability and feasibility of implementation strategies for colorectal cancer screening by conducting a pilot trial and using mixed methods.

V. Determine acceptability and feasibility of implementation strategies to increase uptake of timely diagnostic colonoscopy after positive FIT test using mixed methods.

OUTLINE:

AIM 1: Participants complete a survey and participate in an in-depth interview on study.

AIM 2: Barrier-strategy combinations are developed using systems-level determinants identified in Aim 1 matched to potential implementation strategies.

AIM 3: The 2 highest ranking barrier-strategy combinations identified in Aims 1 and 2, system-level strategy 1 for 6 months and system-level strategy 2 for 6 months are tested separately for a total of 12 months. After 12 months, the most feasible and acceptable strategy will continue to be used and measured for 6 months.