000			04429nam a22005777a 4500
008			240807s20242024 xxu||||| |||| 00| 0 eng d
022			_a2662-2211
024			_a10.1186/s43058-024-00598-5 [pii]
024			_aPMC11149321 [pmc]
040			_aOvid MEDLINE(R)
099			_a38831365
245			_aSupporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care.
251			_aImplementation Science Communications. 5(1):60, 2024 Jun 03.
252			_aImplement. sci. commun.. 5(1):60, 2024 Jun 03.
253			_aImplementation science communications
260			_c2024
260			_fFY2024
260			_p2024 Jun 03
265			_sepublish
265			_tPubMed-not-MEDLINE
266			_d2024-08-07
266			_z2024/06/03 23:45
520			_aBACKGROUND: Black individuals in the United States (US) have a higher incidence of and mortality from colorectal cancer (CRC) compared to other racial groups, and CRC is the second leading cause of death among Hispanic/Latino populations in the US. Patient navigation is an evidence-based approach to narrow inequities in cancer screening among Black and Hispanic/Latino patients. Despite this, limited healthcare systems have implemented patient navigation for screening at scale.
520			_aDISCUSSION: Primary care clinics are poised to close disparity gaps in CRC screening completion but may lack an understanding of the magnitude of these gaps and how to address them. We aim to understand how to tailor a patient navigation program for CRC screening to patients and providers across diverse clinics with wide variation in baseline screening rates, payor mix, proximity to specialty care, and patient volume. Findings from this study will inform other primary care practices and health systems on effective and sustainable strategies to deliver patient navigation for CRC screening among racial and ethnic minorities.
520			_aMETHODS: We are conducting a stepped-wedge cluster randomized trial of 15 primary care clinics with six steps of six-month duration to scale a patient navigation program to improve screening rates among Black and Hispanic/Latino patients. After six months of baseline data collection with no intervention we will randomize clinics, whereby three clinics will join the intervention arm every six months until all clinics cross over to intervention. During the intervention roll out we will conduct training and education for clinics, change infrastructure in the electronic health record, create stakeholder relationships, assess readiness, and deliver iterative feedback. Framed by the Practical, Robust Implementation Sustainment Model (PRISM) we will focus on effectiveness, reach, provider adoption, and implementation. We will document adaptations to both the patient navigation intervention and to implementation strategies. To address health equity, we will engage multilevel stakeholder voices through interviews and a community advisory board to plan, deliver, adapt, measure, and disseminate study progress. Provider-level feedback will include updates on disparities in screening orders and completions.
520			_aTRIAL REGISTRATION: NCT06401174. Copyright © 2024. The Author(s).
546			_aEnglish
650			_zAutomated
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aHealth Equity
656			_aMedicine/Internal Medicine
656			_aMedStar Health
656			_aMedStar Institute for Quality and Safety
656			_aSurgery
657			_aJournal Article
700			_aArem, Hannah _bMHRI
700			_aBlumenthal, H Joseph _bMHRI
700			_aGalarraga, Jessica E _bMSH
700			_aGrady, MelanieMIQS
700			_aLocke, Marjorie _bMWHC
700			_aMete, Mihriye _bMHRI
700			_aRivera Rivera, Jessica N _bMHRI
700			_aSchubel, Laura C _bMHRI
700			_aStarling, Claire _bMHRI
700			_aTran, Jennifer _bMWHC
790			_aRivera Rivera JN, AuBuchon KE, Schubel LC, Starling C, Tran J, Locke M, Grady M, Mete M, Blumenthal HJ, Galarraga JE, Arem H
856			_uhttps://dx.doi.org/10.1186/s43058-024-00598-5 _zhttps://dx.doi.org/10.1186/s43058-024-00598-5
858			_yArem, Hannah _uhttp://orcid.org/0000-0002-5734-0810 _zhttp://orcid.org/0000-0002-5734-0810
942			_cART _dArticle
999			_c14489 _d14489