Focus Area: Community-Clinical Linkages
Colorectal Cancer Screening Change Package
The community-clinical linkages focus area includes tools and resources to—
- Engage community members and organizations to support screening efforts.
- Reduce structural barriers to screening in the community.
- Implement bi-directional outreach and referral between community and clinical organizations.
- Change concepts are “general notions that are useful for developing more specific strategies for changing a process.”1
- Change ideas are evidence-based or practice-based “actionable, specific ideas or strategies.”1
- Each change idea is linked to tools and resources that can be used or adapted to improve cancer screening.
Notes
- Tools and resources with a symbol may contain some information that does not reflect the current US Preventive Services Task Force (USPSTF) recommendations for colorectal cancer screening.
- Tools and resources with a symbol are patient resources.
See a list of acronyms used in this change package.
Change Concept: Engage community members and organizations to support screening efforts.
Tools and Resources, by Change Idea
Engage or train community leaders and others.
- CCSPSC — CCSPSC Champions Program [PDF-3.2MB], see activities, pages 22–30
- NCCRT and ACS — Colorectal Cancer Screening: Best Practices Handbook for Health Plans [PDF-8.3MB], pages 25–26
Change Concept: Engage community-based health professionals to refer or recommend individuals for screening.
Tools and Resources, by Change Idea
Engage pharmacists to deliver home-based screening tests or recommend and refer individuals for screening.
- Brenner A, Rohweder C, Wangen M, Atkins D, Ferrari R, Chilampath B, Luther C, Reuland D, Shah P, Wheeler S, 2020 — PharmFIT: Perspectives from Primary Care Providers on a Pharmacy-Based Distribution of Fecal Immunochemical Test (FIT) Kits for Home Colorectal Cancer Screening
- Fight Colorectal Cancer — Take-Home Test for Colorectal Cancer Approved in Kentucky Pharmacies
- Kentucky Board of Pharmacy — Colorectal Cancer (CRC) Screening Protocol v1 [PDF-201KB]
Engage community health workers to recommend and refer individuals for screening.
- Evidence-Based Cancer Control Programs (EBCCP) — Against Colorectal Cancer in Our Neighborhoods (ACCION), see Program Materials
- President’s Cancer Panel — Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access [PDF-14MB], pages iii and 18–21
The Community Guide — Cancer Screening: Interventions Engaging Community Health Workers – Colorectal Cancer
Change Concept: Reduce structural barriers to screening in the community.
Tools and Resources, by Change Idea
Enlist patient navigators or community health workers to help individuals access screening.
- ACS and CCCNP — Comprehensive Cancer Control Plan: Colorectal Cancer Tip Sheet [PDF-562KB], page 9
- Evidence-Based Cancer Control Programs (EBCCP) — Against Colorectal Cancer in Our Neighborhoods (ACCION), see Program Materials [English and Spanish]
- GW Cancer Center — Guide for Patient Navigators: A Supplement to the Oncology Patient Navigator Training: The Fundamentals [PDF-2.7MB], pages 7–9 and 64–69
- GW Cancer Center — Together, Equitable, Accessible, Meaningful (TEAM) Training [CEU course, free, registration required]
- President’s Cancer Panel — Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access [PDF-14MB], pages 19–20
The Community Guide — Cancer Screening: Interventions Engaging Community Health Workers – Colorectal Cancer
Identify transportation or transportation vouchers for screening appointments.
- AHA — Social Determinants of Health Series: Transportation and the Role of Hospitals [PDF-2.6MB]
- CMS — Non-Emergency Medical Transportation (NEMT)
- NIHB — Health Systems Improvement Toolkit: A Guide to Cancer Screenings in Indian Country [PDF-4.2MB], pages 25–26
- The Community Guide — Cancer Screening: Reducing Structural Barriers for Clients – Colorectal Cancer
Identify dependent care so that parents and caregivers can attend screening appointments.
Offer tests that patients can take at home.
- CDC, NACDD, and Kaiser Permanente CHR — Mailed FIT Implementation Guide [PDF-3MB]
- Evidence-Based Cancer Control Programs (EBCCP) — Fecal Immunochemical Test and Colonoscopy Outreach, see Program Materials: FIT Invitation Letter [English and Spanish]
- Kaiser Permanente CHR — Patient Frequently Asked Questions [PDF-210KB] [English and Spanish]
- President’s Cancer Panel — Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access [PDF-14MB], pages iii–iv, 10, 17–18, 21–23, 41, and 60
Use telehealth for screening consultations.
- HHS — Preparing Patients for Telehealth Cancer Care
- President’s Cancer Panel — Closing Gaps in Cancer Screening: Connecting People, Communities, and Systems to Improve Equity and Access [PDF-14MB], pages 3 and 17–19
Develop (or use existing) resource and information hubs, such as 211, to address the intersection of health and social services and help individuals access screening.
- 211 — Healthcare Expenses
- Evidence-Based Cancer Control Programs (EBCCP) — Against Colorectal Cancer in Our Neighborhoods (ACCION), see Program Materials
- Findhelp.org — FindHelp [multiple languages]
Change Concept: Implement bi-directional outreach and referral systems for screening.
Tools and Resources, by Change Idea
Establish formal partnerships or systems between health care organizations and community-based organizations to ensure clinical and community linkages to screening.
- BMC and AVON Foundation for Women — The Boston Medical Center Patient Navigation Toolkit 1st edition [PDF-807KB], pages 21–29
- CDC — You Can Help Get More People Screened for Cancer
- Illinois Colon CARES (Cancer Alliance to Reignite and Enhance Screening) — Illinois Colon CARES
Reference
1Centers for Disease Control and Prevention. Tobacco Cessation Change Package. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Department of Health and Human Services; 2019.