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| Name | Class |
|---|---|
| Oklahoma City Indian Clinic | UNKNOWN |
| Indian Health Service (IHS) | FED |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| American Indians needing diagnostic colonoscopy after a positive stool-based screen. | In year 1; baseline proportion of patients needing diagnostic colonoscopy (after an initial positive stool-based screen) who receive it within 30 days, 60 days, and 90 days over the 12 months of Year 1 will be calculated, with 60-day completion being the primary focus. Findings will be analyzed by age group, gender, geographic residence location using Rural-Urban Continuum Codes (RUCCs),91 health insurance coverage status, and clinic. |
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| provider/staff/leadership | Employees above 18 years old or people not employed by the participating clinics will be given 32-item Change Process Capability Questionnaire (CPCQ). The CPCQ measures practice readiness to manage the system changes needed to implement evidence-based recommendations by incorporating items identified by a panel of implementation leaders as the most important organizational factors and strategies. Three to six individuals per site will complete pre- and post CPCQs: 1-2 project champion clinicians; 1-2 nursing staff; 1-2 admin. staff (e.g., office manager). | ||
| caregivers/community members | 50 provider/community interviews will per collected to develop strategies that address potential barriers and facilitators to diagnostic follow-up within each ITU setting using a Navigator-led intervention. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Navigator-led intervention | Other | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Effects of a clinical intervention on CRC diagnostic testing outcomes | 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. | 4 year |
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Inclusion Criteria:
Exclusion Criteria:
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American Indian (AI) adults aged 45-75 years with positive stool-based screens who are successfully navigated to diagnostic colonoscopy within 60 days.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mark Doescher, MD, MSPH | Contact | 05-271-4808 | SCC-IIT-Office@ouhsc.edu |
| Name | Affiliation | Role |
|---|---|---|
| Mark Doescher, MD, MSPH | University of Oklahoma Stephenson Cancer Center | Principal Investigator |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |