Project COALESCE—An Example of Academic Institutions as Conveners of Community-Clinic Partnerships to Improve Cancer Screening Access

Abstract

In Virginia, 56% of colorectal cancers (CRC) are diagnosed late, making it one of three enduring CRC mortality hotspots in the US. Cervical cancer (CCa) exhibits a similar pattern, with 48% late-stage diagnosis. Mortality for these cancers is worse for non-Latinx/e(nL)-Black people relative to nL-White people in Virginia, but preventable with equitable screening access and timely diagnostic follow-up. However, structural barriers, such as fractured referral systems and extended time between medical visits, remain. Because Federally Qualified Health Centers (FQHCs) care for a large proportion of racial and ethnic minorities, and underserved communities, regardless of ability to pay, they are ideal partners to tackle structural barriers to cancer screenings. We piloted a quality improvement initiative at five FQHCs in southcentral Virginia to identify and address structural, race-related barriers to CRC, as well as CCa screening and diagnostic follow-up using evidence-based approaches. Uniquely, FQHCs were paired with local community organizations in a didactic partnership, to elevate the community’s voice while together, increase support, acceptance, uptake, and intervention sustainability. We report on project development, and share preliminary data within the context of project goals, namely, to increase cancer screenings by 5–10%, improve knowledge and diagnostic follow-up processes, and build longitudinal partnerships.

Implementation of evidence-based primary cancer prevention interventions in MA community health centers: an explanatory sequential mixed methods study

“…An extension of this implementation science research would be to determine the distinction between offering and actual utilization of cancer prevention EBIs. Our findings and the minimal body of research we build upon [ 10 – 13 ], highlight the importance of increasing evaluation of EBIs and homegrown programs within FQHC and community settings. Such practice-based evidence will help establish better understanding of what strategies are most feasible, accessible, and effective for addressing cancer prevention [ 33 ].…”

“…Yet, understanding the usage of evidence-based behavioral interventions addressing nutrition, physical activity, and tobacco use, which have the potential for the prevention of cancer and other chronic diseases, is more limited. Clinical-community linkages have been lifted up as promising opportunities for chronic disease prevention within research [ 10 – 13 ] and the Agency for Healthcare Research and Quality [ 14 ]. These linkages build trust and promote access to disease prevention and treatment to “improve care and support patients better than either of these sectors could do alone” [ 15 ].…”