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CDC Call-On Congress 2012
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CDC Call-On Congress 2012

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Djenaba A. Joseph, MD, MPH

Djenaba A. Joseph, MD, MPH
Medical Director, Colorectal Cancer Control Program, Division of Cancer Prevention and Control, NCCDPHP

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    CDC Call-On Congress 2012 CDC Call-On Congress 2012 Presentation Transcript

    • CDC’s Colorectal Cancer Control Program Djenaba A. Joseph, MD, MPH Medical Director, Colorectal Cancer Control Program Center for Disease Control and Prevention Division of Cancer Prevention and Control Division of Cancer Prevention and Control Centers for Disease Control and Prevention
    • CDC Office of Non-Communicable Diseases, Injury, and Environmental HealthNational Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control
    • CRC Demonstration Screening Program 2005-2009• CDC designed CRC demonstration screening program – To determine feasibility of establishing organized screening program for underserved population using federal funds – To learn how best to implement CRC screening at community level – To explore NBCCEDP model – To inform current and future organized CRC screening efforts
    • Clallam County King County Nebraska St. LouisJefferson County Suffolk County Baltimore CityColorectal Cancer Demonstration Screening Sites 2005-2009
    • COLORECTAL CANCERCONTROL PROGRAM (CRCCP) 2009 - 2014
    • CRCCP State & Tribal Grantees CRCCP State Grantees and Tribal Grantees Funded 2009–11 Fiscal Year 2010Awarded$26.9 M to 25 states and 4 tribal groups
    • GoalsColorectal Cancer Control Program • Increase high-quality CRC screening among persons 50 years and older to 80% nationwide by 2014. • Reduce disparities in CRC burden, screening and access to care.
    • Colorectal Cancer Control Program• Two broad functions that are parallel, but separate tracks in terms of program development and evaluation planning:• Providing CRC screening to low-income, un- and under- insured men and women• Promoting CRC to all persons, insured and uninsured who are aged 50 and older for whom CRC screening is recommended• Both contribute to achieving our program goal to increase CRC screening rates to 80% at the population- level by 2014
    • Providing CRC Screening• Direct service delivery of CRC screening and diagnostic services to target population: – Men and women aged 50 – 64 years – Underinsured or uninsured for screening services – 250% Federal Poverty Level or lower
    • CRC Screening Test Options USPSTF Colonoscopy High-sensitivity gFOBT or FIT Flexible sigmoidoscopy with HS-gFOBT or FIT
    • Promoting CRC Screening• Implementation of activities aimed to increase population-level screening rates: – Policy – Health Systems – Health Care Providers – Public Awareness and Education – Strategic Partnerships – Communities
    • Community Guide Goals• Systematic reviews of interventions to promote health and prevent disease• Evidence-based recommendations issued by the Task Force• Highlight important research gaps
    • Grantee Required Activities CRCCP Program Framework1. *Client reminder systems (esp where large populations reached)2. *Small media (well designed, audience-appropriate informational or motivational videos, brochures, newsletters, checklists)3. *Structural barriers (Patient navigator programs to address identified barriers)4. *Provider assessment and feedback5. *Provider reminder systems
    • A Social Ecological Model 15
    • Program Logic Model (Simplified) 16
    • Implementation, Outcome, Impact Evaluation Implementation Outcomes – Secondary analysis of BRFSS and USCS data on annual basis Impact – Quasi-experimental control-group design with pre and post testing with six states
    • Evaluation Implementation,Outcome and Impact Clinical Services Program Cost Indirect/non-medical
    • CRC Screening Promotion Achievements and Challenges by Partner Type, Year 1 Partner Type Achievements ChallengesPrivate and nonprofit health care  Recruit individuals for CRC screening  No significant challengessystemsFederally Qualified Health Centers  Recruit individuals for CRC screening  No significant challenges  Implement patient navigationPrivate health insurers  Implement patient and provider  Scheduling a meeting with staff reminder systems  Agreeing on shared goals  Influencing partner to view CRC screening as a priorityState Medicaid office  Develop a small media campaign  Identifying the right person to contact  Support insurance enrollment  Scheduling a meeting with staff  Promote use of performance measures  Agreeing on shared goals (HEDIS)Employers and work sites  Recruit individuals for CRC screening  Agreeing on shared goals  Education of employees regarding the  Influencing partner to view CRC importance of CRC screening screening as a priority  Identifying ways for partner to contributeProfessional organizations  Drafted/supported the passage of CRC  Identifying the right person to contact screening legislation  Scheduling a meeting with staff  Recruit individuals for CRC screening  Influencing partner to view CRC screening as a priority  Identifying ways for partner to contribute Data Source: Grantee Interim Progress Reports, February 2010
    • CRC Screening Provision Clients screened  14,600 • 7,400 gFOBT/FIT • 7,157 colonoscopy 2,050 adenomas 36 cancers
    • Thank you! dajoseph@cdc.govFor more information please contact Centers for Disease Control andPrevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: cdcinfo@cdc.gov Web: www.cdc.govThe findings and conclusions in this report are those of the authors and do not necessarily represent the officialposition of the Centers for Disease Control and Prevention. National Center for Chronic Disease Prevention and Health Promotion Division of Cancer Prevention and Control