Impact of a Low-Cost, Multicomponent Intervention to Improve Colorectal Cancer Screening Rates at Two Primary Care Clinics in Rural Kansas

Abstract

Problem Statement: Residents in rural Kansas have lower colorectal cancer screening rates and therefore are more likely to experience poorer outcomes from colorectal cancer. Purpose: Determine the effectiveness of a low-cost multicomponent intervention on improving colorectal cancer screening rates on patients seen in two primary care clinics in rural Kansas. Methods: A quality improvement pre-post intervention study design was used to determine if colorectal cancer screening rates increase within 3 months of the implementation of a multicomponent intervention. The intervention consisted of two components: 1) postcard educational mailers and electronic educational mailers and 2) medical assistant and registered nurse education on colorectal cancer screening and in-clinic order process. Inclusion Criteria: Male and female patients aged 50-75 seen at the Family Care Center in Garnett, Kansas and the Family Care Center South in Colony, Kansas from July 2018 to September 2018 who were overdue for colorectal cancer screening received a postcard mailer or an electronic mailer about colorectal cancer screening. Male and female patients aged 50-75 who visited the Clinics from October 2018 to December 2018 were assessed for colorectal cancer screening adherence and a colorectal cancer screening order was placed, if applicable. Analysis: Post-intervention colorectal cancer screening rates from Quarter 4 (October 1, 2018 to December 31, 2018) were compared to colorectal cancer screening rates pre-intervention during Quarter 3 (July 1, 2018 to September 30, 2018). Results: The Clinics had an increase in post-intervention colorectal cancer screening rate when compared to pre-intervention screening rate. The colorectal cancer screening rate had the largest increase in the two months following the intervention implementation. Significance: Improving colorectal cancer screening rates using low-cost interventions may improve the health of residents in rural Kansas. The multicomponent intervention may offer an inexpensive way to improve colorectal cancer screening adherence in rural areas of the United States where healthcare resources may be scarce. Key Words: colorectal cancer, screening, rural health, preventative health