Prajakta Adsul, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA; Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA
Kevin English, Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
Cheyenne Jim, Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA
V Shane Pankratz, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA; Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA
Nicholas Edwardson, University of New Mexico School of Public Administration, Albuquerque, NM, USA
Judith Sheche, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
Joseph Rodman, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
Jimmie Charlie, Kewa Pueblo Health Corporation, Kewa Pueblo, NM, USA
John Pagett, Kewa Pueblo Health Corporation, Kewa Pueblo, NM, USA
Jonathan Trujillo, Kewa Pueblo Health Corporation, Kewa Pueblo, NM, USA
Jillian Grisel-Cambridge, Jemez Health & Human Services, Jemez Pueblo, NM, USA
Steven Mora, Jemez Health & Human Services, Jemez Pueblo, NM, USA
Kaitlyn L. Yepa, Jemez Health & Human Services, Jemez Pueblo, NM, USA
Shiraz I. Mishra, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA; Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, NM, USA; Department of Family and Community Medicine, University of New Mexico Health Sciences Center, 1 University of New Mexico, MSC 10 5590, Albuquerque, NM, 87131, USAFollow

Document Type

Article

Publication Date

5-10-2024

Abstract

BACKGROUND: Despite the effectiveness of colorectal cancer (CRC) screening, American Indians (AIs) have low screening rates in the US. Many AIs receive care at Indian Health Services, Tribal, and Urban Indian (I/T/U) healthcare facilities, where published evidence regarding the implementation of CRC screening interventions is lacking. To address this gap, the University of New Mexico Comprehensive Cancer Center and the Albuquerque Area Southwest Tribal Epidemiology Center collaborated with two tribally-operated healthcare facilities in New Mexico with the goal of improving CRC screening rates among New Mexico's AI communities.

METHODS: Guided by the principles of Community Based Participatory Research, we engaged providers from the two tribal healthcare facilities and tribal community members through focus group (two focus groups with providers (n = 15) and four focus group and listening sessions with community members (n = 65)), to elicit perspectives on the feasibility and appropriateness of implementing The Guide to Community Preventive Services (The Community Guide) recommended evidence-based interventions (EBIs) and strategies for increasing CRC screening. Within each tribal healthcare facility, we engaged a Multisector Action Team (MAT) that participated in an implementation survey to document the extent to which their healthcare facilities were implementing EBIs and strategies, and an organizational readiness survey that queried whether their healthcare facilities could implement additional strategies to improve uptake of CRC screening.

RESULTS: The Community Guide recommended EBIs and strategies that received the most support as feasible and appropriate from community members included: one-on-one education from providers, reminders, small media, and interventions that reduced structural barriers. From the providers' perspective, feasible and acceptable strategies included one-on-one education, patient and provider reminders, and provider assessment and feedback. Universally, providers mentioned the need for patient navigators who could provide culturally appropriate education about CRC and assist with transportation, and improved support for coordinating clinical follow-up after screening. The readiness survey highlighted overall readiness of the tribal facility, while the implementation survey highlighted that few strategies were being implemented.

CONCLUSIONS: Findings from this study contribute to the limited literature around implementation research at tribal healthcare facilities and informed the selection of specific implementation strategies to promote the uptake of CRC screening in AI communities.

Publication Title

Implement Sci Commun

ISSN

2662-2211

Volume

5

Issue

1

First Page

55

Last Page

55

DOI

10.1186/s43058-024-00591-y

Language (ISO)

English

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