Although colorectal cancer outcomes greatly improve with screenings, less than half the population in low-income, racially diverse Federally Qualified Health Centers (FQHCs) is up-to-date. Annual fecal immunochemical tests (FIT), which can be taken at home and mailed in for analysis, may help attenuate observed screening disparities, but return rates can vary widely.

ORPRN's Associate Director Melinda Davis, PhD, recently collaborated on a study led by Dr. Gloria Coronado at the Kaiser Permanente Center for Health Research designed to optimize mailed FIT programs within an urban FQHC system. The team used a novel analytic approach to identify modifiable, clinic-level factors that distinguish clinics with higher versus lower FIT completion rates in response to a centralized mailed FIT program. As it turned out, the difference was support staff: Clinics with higher rates had either added support staff, had staff help patients resolve barriers to screening, or had staff hand out FITs/provide education. Clinics with lower rates displayed none of these factors. 

The article, "Clinic Factors Associated With Mailed Fecal Immunochemical Test (FIT) Completion: The Difference-Making Role of Support Staff," was published in the March/April 2022 edition of the Annals of Family Medicine. Read it here.

"This is one of the most exciting publications that I’ve been involved with given our findings that highlight the key role that clinic-based staff play in relation to screening completion rates for a centralized mailed FIT outreach program," notes Davis. "I think many of us are aware of the key role that support staff play in supporting preventive behaviors during scheduled clinic encounters, but our findings suggest these behaviors also have an impact on the effectiveness of population outreach programs."