Building Cancer Prevention and Control Research Capacity in Rural Appalachian Kentucky Primary Care Clinics During COVID-19: Development and Adaptation of a Multilevel Colorectal Cancer Screening Project.
J Cancer Educ
; 37(5): 1407-1413, 2022 10.
Article
in English
| MEDLINE | ID: covidwho-1086693
ABSTRACT
This study describes the development of a colorectal cancer (CRC) screening multilevel intervention with four primary care clinics in rural Appalachian Kentucky. We also discuss barriers experienced by the clinics during COVID-19 and how clinic limitations and needs informed project modifications. Four primary care clinics were recruited, key informant interviews with clinic providers were conducted, electronic health record (EHR) capacity to collect data related to CRC screening and follow-up was assessed, and a series of meetings were held with clinic champions to discuss implementation of strategies to impact clinic CRC screening rates. Analysis of interviews revealed multilevel barriers to CRC screening. Patient-level barriers included fatalism, competing priorities, and financial and literacy concerns. The main provider- and clinic-level barriers were provider preference for colonoscopy over stool-based testing and EHR tracking concerns. Clinics selected strategies to address barriers, but the onset of COVID-19 necessitated modifications to these strategies. Due to COVID-19, changes in clinic staffing and workflow occurred, including provider furloughs, a state-mandated pause in elective procedures, and an increase in telehealth. Clinics adapted screening strategies to match changing needs, including shifting from paper to digital educational tools and using telehealth to increase annual wellness visits for screening promotion. While significant delays persist for scheduling colonoscopies, clinics were encouraged to promote stool-based tests as a primary screening modality for average-risk patients.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Colorectal Neoplasms
/
COVID-19
Type of study:
Cohort study
/
Diagnostic study
/
Prognostic study
/
Qualitative research
Topics:
Long Covid
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Cancer Educ
Journal subject:
Education
/
Neoplasms
Year:
2022
Document Type:
Article
Affiliation country:
S13187-021-01972-w
Similar
MEDLINE
...
LILACS
LIS