Initiating Colorectal Cancer Screening in Unscreened Individuals 45 to 54

Massachusetts General Hospital, Boston MA

Investigators

Abstract

Colorectal cancer (CRC) is the first and second leading cause of cancer death in men and women under 50, respectively. Community health centers (CHCs) predominantly serve low-income individuals and have lower screening rates (41.9%) compared to the general population (69.7%). Low screening rates, and rising incidence and mortality from CRC in adults at younger ages also suggests that focusing on increasing screening uptake from 45 to 54 is a critical target. This career development award leverages an existing partnership with Codman Square Health Center, a CHC with 87% of patients at or below the federal poverty limit, to develop implementation strategies to initiate CRC screening in previously unscreened individuals age 45 to 54 at CSHC. Dr. Adjoa Anyane-Yeboa’s long-term career goal is to use implementation science methods to reduce rates of CRC in low-income populations. The proposed project blends rigorous methodologic training with an innovative research agenda to facilitate Dr. Anyane-Yeboa’s development into an independent investigator through three training goals: (1) enhance quantitative and qualitative research skills, (2) design and conduct mixed methods research to inform implementation of evidence-based interventions, and (3) learn implementation science methods with a focus on community-engagement. This proposal has three scientific aims: (1) identify system-level determinants of CRC screening in individuals 45 to 54 using mixed methods; (2) identify systems-level implementation strategies to initiate CRC screening matched to systems-level determinants; and (3) determine the acceptability and feasibility of implementation strategies for CRC screening by conducting a pilot trial and using mixed methods. In addition to advanced training through formal coursework, this award is supported by an extraordinary mentorship team, including internationally-recognized experts in CRC prevention, implementation science, community-engaged research, and mixed methods. Upon completion of the proposed research and training, Dr. Anyane-Yeboa will expand her findings in an R01 to rigorously test her findings in a trial across CHCs in Massachusetts. The combination of formal training and mentored research outlined in this application is designed to ensure that Dr. Anyane-Yeboa will emerge from this award as a nationally recognized independent investigator with the skills and experience to improve CRC screening in low-income populations.