Colorectal Cancer (CRC)
Conditions
Keywords
American Indian (AI), Implementation Science (IS), Alaskan Native (AN)
Brief summary
This study focuses exclusively on American Indian individuals within their communities to enhance health equity and address a critical tribal health priority. American Indian populations experience some of the highest colorectal cancer (CRC) mortality rates in the nation. By conducting research within these communities, this study aims to improve early detection, prevention, and treatment strategies tailored to their specific needs. The findings will help develop targeted interventions to reduce CRC disparities and improve health outcomes for American Indian individuals.
Detailed description
This study aims to close gaps in diagnostic follow-up for American Indian (AI) patients by identifying barriers and facilitators to receiving diagnostic colonoscopies, with a focus on social determinants of health (SDOH). Insights from this will guide an implementation science (IS) study evaluating a CRC Screening Navigator-led intervention to improve access. The primary outcome is the annual percentage change in AI adults (ages 45-75) with positive stool-based screens who complete a diagnostic colonoscopy within 60 days.
Interventions
OTHERNavigator-led intervention
Navigator will review the proposed implementation plan with PCPs, clinic staff and administrators to address how diagnostic colonoscopy can fit smoothly within overall clinic operations.
Sponsors
University of Oklahoma
Oklahoma City Indian Clinic
Indian Health Service (IHS)
Study design
Observational model
ECOLOGIC_OR_COMMUNITY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* Inclusion for patient interviews: American Indian Men and Women eligible for services at OKCIC and IHS facilities. American Indian Men and Women aged 45 to 75 years who are eligible for colorectal cancer screening. * Inclusion for the provider/staff/leadership interviews: Adults (18 to 80 years old) who are employed by the participating clinic. * Inclusion for caregiver/community member interviews: Adults aged 18 and over who are caregivers for patients eligible for CRC screening. Community members who are aged 18 and over.
Exclusion criteria
* Exclusion for patient interviews: Non-American Indian Men and Women and American Indian Men and Women that are not in the required age range for CRC screenings. * Exclusion for provider/staff/leadership interviews: Employees less than 18 years old or people not employed by the participating clinics. * Exclusion for caregivers/community members: People less than 18 years old, not a caregiver for a patient eligible for CRC screening. People less than 18 years old and not a member of the community where the participating clinics are located.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effects of a clinical intervention on CRC diagnostic testing outcomes | 4 year | Measures the percentage of screen-positive patients successfully navigated to diagnostic colonoscopy within 60 days. The study will use a Hybrid Type 2 pretest/posttest design. A pretest pilot (40 patients across all sites) will inform full-scale implementation, completed in Year 2 within six months. Full-scale implementation (252 patients) will run from Year 2, Month 7 to Year 4, Month 6, assessing pragmatic effectiveness and implementation outcomes. |
Contacts
CONTACTMark Doescher, MD, MSPH
PRINCIPAL_INVESTIGATORMark Doescher, MD, MSPH
University of Oklahoma Stephenson Cancer Center
Outcome results
None listed