Investigators compared screening rates of FQHCs funded by CHANGE grants to those of matched controls
An American Cancer Society (ACS) programme has been effective in promoting improvements in colorectal cancer screening rates in federally qualified health centres (FQHCs) and could have implications for broader public health efforts to increase cancer prevention and screening, according to a study published online in the American Journal of Preventive Medicine.
In 2013, ACS initiated the Community Health Advocates Implementing Nationwide Grants for Empowerment and Equity (CHANGE) grant programme, which was designed to reduce breast and colorectal cancer screening disparities by building community capacity to implement evidence-based interventions proven to increase cancer screening rates. Funding is awarded to FQHC partners, with technical assistance provided by ACS field staff.
Funded FQHCs were required to implement at least one provider-oriented strategy (provider assessment and feedback or provider reminder/recall systems) and at least one client-oriented strategy (education, client reminders, or navigation). Most grantees (88.4%) implemented three to five intervention strategies throughout their funding period.
Investigators compared screening rates of FQHCs funded by CHANGE grants to those of matched controls. At the start of the study period, colorectal cancer screening rates were low across the board, with funded FQHCs lagging nonfunded FQHCs (26.4% vs 30.4%).
In the first year (2013-2014), funded FQHCs increased their CRC screening rates significantly more than nonfunded FQHCs. Funded FQHCs increased by 8.7% (from 26.4% to 35.1%) while nonfunded FQHCs increased by 2.7% (from 28.5% to 31.2%). Across the three years, increases were 12.7% (from 26.4% to 39.1%) and 9.0% (from 28.5% to 37.5%), respectively. The difference in change rates between groups across the three years was not significant.
"Even in the absence of the ACS grant funds, many FQHCs increased their CRC screening rates substantially during the 3-year period," the authors noted. "The 80% by 2018 CRC campaign is a national initiative that serves as a catalyst for concentrated focus on CRC screening and may have contributed to an overall increase in CRC screening rates…Funding that results in targeted, intensive efforts supported by technical assistance and accountability for data and reporting, can result in improved system policies and practices that, in turn, can increase screening rates among uninsured and underserved populations."
“The findings suggest grant funding was effective in promoting improvements in colorectal cancer screening rates in funded federally qualified health centres, and these improvements exceed those of nonfunded federally qualified health centres,” they conclude. “Although the amount of funding provided was relatively small compared with the overall operating budget for these systems, in some cases funds were utilised for salary support. In the absence of continued funding, it is unclear to what extent FQHCs will be able to continue activities supporting the grant programme.”
To access the paper, ‘Evaluation of Colorectal Cancer Screening in Federally Qualified Health Centers', please click here