The purpose of this study is to evaluate the effectiveness of the West Virginia Program to Increase Colorectal Cancer Screening in implementing patient reminders to increase fecal immunochemical test (FIT) kit return rates in nine federally qualified health centers (FQHCs). Using process measures and cost data collected, the authors examined the differences in the intensity of the phone calls across FQHCs and compared them with the return rates achieved. They also reported the cost per kit successfully returned as a result of the intervention. Across all FQHCs, 5,041 FIT kits were ordered, and the initial return rate (without a reminder) was 41.1%. A total of 2,201 patients received reminder phone calls; on average, patients received 1.61 reminder calls each. The reminder interventions increased the average FIT kit return rate to 60.7%. The average total cost per FIT kit returned across all FQHCs was $60.18, and the average cost of only the reminders was $11.20 per FIT kit returned. FQHCs achieved an average increase of 19.6 percentage points in FIT kit return rates, and costs across clinics varied. Clinics with high-quality health information systems that enabled tracking of patients with minimal effort were able to implement lower cost reminder interventions.

Background: Despite policies such as the Women's Health and Cancer Rights Act (WHCRA) and Breast Cancer Patient Education Act, rates for breast reconstruction vary and are especially low for some subpopulations of patients, especially rural women. In order to better understand patient perceptions, qualitative analysis using focus groups is an underutilized tool for obtaining patient perspectives regarding health-related issues and access to care. Our aim was to better understand patient perceptions using qualitative analysis. Methods: Three focus groups were held in rural counties within West Virginia in order to better understand patient perceptions, knowledge, and beliefs regarding breast health, breast cancer, access to breast reconstruction, and how to disseminate and educate this patient population regarding their right to accessing breast reconstruction. Results: Major themes analyses revealed perceived barriers to care related to lacking care coordination, lack of insurance coverage and other resources, as well as issues related to transportation. Participants consistently discussed avoiding breast screening care due fear and denial in addition to pain. Few patients were aware of their right to accessing breast reconstruction per the WHCRA, and many were concerned about follow-up burden, complications, and general fear related to breast reconstruction. Themes related to dissemination of information to promote the option of breast reconstruction included social media, patient counseling by their referring physician, and other means of intervention in clinics and other points in the care coordination chain. Conclusions: Rural women have important, unique viewpoints regarding access to and perceived barriers from obtaining breast reconstruction. Plastic surgeons must work diligently to educate, disseminate, and improve care coordination among this population in order to improve access to breast reconstruction among rural breast cancer patients.

Background The human papillomavirus (HPV) vaccine is viewed as a critical tool to protect against six HPV-related cancers. Vaccination is recommended from early adolescence through age 26 years. As young people have become increasingly involved in personal health-related decisions, there is a need to tailor HPV vaccine messaging and reach this priority population on social media and digital outlets. TikTok is a growing social media platform with approximately 70% of its users between the ages of 13 and 24 years. Purpose The aim of this study was to understand HPV vaccine messaging and interactions on TikTok as a needed first step to identifying effective strategies to reach young people with important health messaging. Methods Content analysis was performed on 170 top TikToks focused on the HPV vaccine. TikToks were assessed for content, classification type, and number of interactions. Results Most TikToks were provaccine, while antivaccine TikToks had more user interactions. Cancer and prevention were the main content areas of the analyzed provaccine TikToks, while the side effects were the primary focus of antivaccine messages. Approximately 30% of all top TikToks analyzed were developed by health professionals. TikToks without an explicit vaccine opinion primarily described personal experiences and mentioned side effects most often. Implications TikTok is a growing social media platform that can be used to reach young people and encourage HPV vaccine uptake. Health professionals need to consider the interest that users have in personal experiences and address antivaccine narratives related to side effects.

Introduction: WVU Cancer Institute’s Cancer Prevention and Control (CPC) and the Patient Advocate Foundation (PAF) is working to address lung cancer disparities in West Virginia (WV). Their goal is to decrease lung cancer mortality, the leading cause of cancer deaths in WV, and improve early diagnosis of lung cancer in the state. Brief Description: In 2016 there was no infrastructure for lung cancer screening in WV. The rural state’s significant geographic barriers, low socioeconomic status, lack of lung cancer screening facilities, and limited provider knowledge regarding screening guidelines created substantial challenges. The major aim of the WV Lung Cancer Project (WVLCP) is to increase lung cancer screening among low-income and limited resourced individuals across WV. The project has three primary components: provider outreach and engagement; patient awareness and education; and case management support. Summary of Data: The WVLCP initially developed a case management (CM) protocol with one of the major Medicaid Managed Care Organizations (MCO) in the state in order to reach those eligible for screening and navigate them to primary care providers for care. The result of protocol implementation was the identification of lack of provider knowledge. The team then surveyed health care providers to further assess their knowledge, attitudes, beliefs, and practices regarding lung cancer screening. The results indicated a need for education on the screening guidelines, including recommended test, frequency, eligibility, and insurance coverage. As a result, project staff provided academic detailing to health care providers and created a continuing education webinar. Beyond the need to enhance health care provider understanding, there was a need to educate the public about lung cancer screening and the location of services. To enhance patient awareness and education, the project established and promoted the WV Lung Cancer CareLine and participated in community education events. Between 2016 and 2019, American College of Radiology (ACR) screening facilities increased from five to 24 sites. The WVLCP was able to facilitate the addition of 12 sites to the ACR Registry by working one-on-one with various health care entities during this time. Two of the MCOs fully implemented the CM protocol. Thousands of patients were assessed, hundreds referred to a primary care provider, tens were screened, and two cases of lung cancer were found. As a result, both companies incorporated the protocol into their operations and have case managers contacting patients to reduce barriers to screening. Conclusion: By partnering with care providers, the public, and health insurance payors, the project has expanded the lung cancer screening infrastructure in WV. As the project concludes in 2019, the state’s comprehensive cancer coalition, Mountains of Hope, will work to promote lung cancer screening in WV and continue the efforts of PAF and the WVUCI. Note: This abstract was not presented at the conference. Citation Format: Stephenie K Kennedy-Rea, Shonta Chambers, Lauren Hixenbaugh. West Virginia Lung Cancer Project [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C117.