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Use of Systems Level Interventions to Improve Colorectal Cancer Screening and Follow-Up

The long-term objective for this project was to increase rates of colorectal cancer (CRC) screening among eligible, average-risk patients in the primary care setting. This project sought to address systems level interventions at the practice sites that make it easier for them to identify average risk patients who have not been screened for CRC and to follow-up with them using a variety of integrated approaches. Specific goals included: Development of IT and EHR systems to capture outreach attempts to patients due for CRC screening, screening activity and outcomes of tests (FOBT, colonoscopy etc.); results of screening and outreach at point of care to encourage dialogue between clinician and patient about CRC; and reminders to increase the number of on-time CRC screening among those due for testing.

The project used epidemiological methods to measure pre- and post-intervention changes in:

  1. identification of patients due for screening;
  2. completion of CRC screening;
  3. compliance with outreach goals (e.g., number of attempts per patient per year); and
  4. user satisfaction with novel systems improvement at the practice level.


Funded through a subcontract from Battelle Memorial Institute, which recieved Task Order funding from the Centers for Disease Control and Prevention.


Evaluation of a systems-level intervention to increase colorectal cancer screening in primary care.
C. Brooke Steele, Gary Chovnick, Judith Lee Smith, April Greek, Kim Kimminau, Anthony Wellever, Diane Manninen, Djenaba Joseph. Abstract presented at the 28th Annual Conference of the American Evaluation Association, Denver, October 15-18, 2014.