Preliminary Findings

We pilot-tested STOP in two clinics of the Virginia Garcia Memorial Health Center. In one clinic, we mailed an introductory letter, a FIT kit, and a reminder to 100 patients. In a second clinic, we mailed to 100 patients all those items and conducted additional outreach designed by the clinic. We identified patients who should be getting colorectal cancer screening based on national guidelines, then used electronic health records to track if patients received the screening, what the results were, and their health outcomes.

Our pilot showed that delivering the STOP program in a safety-net setting was feasible and it seemed to be effective. Over 200 patients received a FIT kit in the mail, and at 6 months, fecal tests were completed at much higher rates for those clinics in the STOP intervention (39.3% and 36.6% for the two intervention groups). The rate of fecal testing in the usual care clinic over the same time period was 1.1%. Now we are expanding this program to 26 clinics and studying how many people complete the test and whether it ultimately improves the health of patients.

Scientific Publications

Coronado GD, Retecki S, Schneider J, Taplin S, Burdick T, Green B. Recruiting community health centers into pragmatic research: Findings from STOP CRC. Clin Trials 1740774515608122, September 29, 2015. 

Larson E, Tachibana C, Thompson E, Coronado G, DeBar L, Dember LM, Honda S, Huang SS, Jarvik JD, Nelson C, Septimus E, Simon G, Johnson KE. "Trials without tribulations: Minimizing the burden of pragmatic research on healthcare systems." Healthcare. (2015) Doi:10.1016/j.hjdsi.2015.07.005i

Coronado GD, Petrik AF, Bartelmann SE, Coyner LA, Coury J. "Health Policy to Promote Colorectal Cancer Screening: Improving Access and Aligning Federal and State Incentives". ACRP Clinical Researcher. February 2015.

Johnson KE, Tachibana C, Coronado GD, Dember LM, Glasgow RE, Huang SS, Martin PJ, Richards J, Rosenthal G, Septimus E, Simon GE, Solberg L, Suls J, Thompson E, Larson EB. A guide to research partnerships for pragmatic clinical trials. BMJ 2014 December 1; 349:g6826.

Coronado GD, Schneider J, Sanchez J, Petrik A, Green B. Reasons for non-response to a direct-mailed FIT kit program: lessons learned from a pragmatic colorectal-cancer screening study in a federally sponsored health center. Translational Behavioral Medicine. 2014 Sept 4. 

Coronado GD, Petrik A, Spofford M, Talbot J, Do HH, Taylor V. Clinical perspectives on colorectal cancer at Latino-serving Federally Qualified Health Centers. Health Education & Behavior. 2014 June 20. [Epub 2014 Jun 20]

 

Coronado GD, Burdick T, Petrik A, Kapka T, Retecki S, Green B. Using an Automated Data-driven, EHR-Embedded Program for Mailing FIT kits: Lessons from the STOP CRC Pilot Study. Journal of General Practice (In press 2014)

 

Green BB, Coronado GD. "BeneFITs" to increase colorectal cancer screening in priority populations. JAMA Intern Med. 2014 Aug 1;174(8):1242-3.

 

Green B, Coronado GD, DeVoe J, Allison J. Navigating the Murky Waters of Colorectal Cancer Screening and Health Reform. American Journal of Public Health. 2014 Jun;104(6):982-6.

 

Coronado GD, Vollmer WM, Petrik A, Taplin SH, Burdick TE, Meenan RT, Green B. Strategies and opportunities to STOP colon cancer in priority populations: Design of a cluster-randomized pragmatic trial. Contemp Clin Trials. 2014 Jun 14;38(2):344-349.

 

Coronado GD, Sanchez J, Petrik A, Kapka T, Devoe J, Green B. Advantages of wordless instructions on how to complete a fecal immunochemical test: Lessons from patient advisory council members of a Federally Qualified Health Center. J Cancer Educ 2014 Mar;29(1):86-90. PMCID: PMC3946071

 

Coronado GD, Vollmer WM, Petrik A, Aguirre J, Kapka T, Devoe J, Puro J, Miers T, Lembach J, Turner A, Sanchez J, Retecki S, Nelson C, Green B.  Strategies and opportunities to STOP colon cancer in priority populations: pragmatic pilot study design and outcomes. BMC Cancer. 2014 Feb 26;14:55. PMCID: PMC3936821

 

Scientific Presentations

Green B. "Optimizing CRC Screening Uptake by Offering Choice and FIT." Washington State Community Physicians, October 2015.

Coronado GD. "Achieving Colon Cancer Screening Improvements in Safety Net Practices." DOH CRC Meeting in Kent, WA, September 29, 2015.

Coronado GD. "How to Design and Refine EMR Tools for CRC Screening." 80% by 2018 conference, Atlanta, GA, September 10, 2015.

Coronado GD. "Finding Non-traditional Allies for CRC Screening." 80% by 2018 conference, Atlanta, GA, September 10, 2015.

Coronado GD. "Improving Colon Cancer Screening in Safety Net Practices: Lessons from the Field." Webinar organized by American Cancer Society, June 24, 2015.

Coronado GD, Petrik A, Bartelmann S, Coyner L. "Oregon's New Medicaid Enrollees: Who are they? Latino Health Equity Conference, June 18, 2015. 

Petrik A, Turner A, Kapka T, Coronado GD. "Continuing to Increase Colorectal Cancer Screening at a Community Clinic." Latino Health Equity Conference, June 18, 2015.  

Petrik A, Coronado GD, Oluloro A, Kapka T, Rivelli J. "Timeliness to Follow-up to an Abnormal Fecal Test Result Among Community Health Center Patients." Latino Health Equity Conference, June 18, 2015.

Green B. "Ethical Considerations of STOP CRC." Think Tank on Bioethics Research at the NCI/NIH campus, June 2015.

Coronado GD. "Colorectal Cancer Screening for Safety Net Practices: Strategies and Opportunities to STOP Colon Cancer in Priority Populations." International Cancer Screening Conference, Rotterdam, Netherlands, May 25, 2015.

Coronado GD. "Improving Colorectal Cancer Screening in Community Clinics: STOP CRC." Oregon Senate Health Committee, May 8, 2015. 

Coronado GD. "Overcoming Barriers to Colon Cancer in Community Health Centers." Partner Training Institute Webinar, WA State Department of Health, April 30, 2015.

Coronado GD, Green B. "Colorectal Cancer Screening in Primary Care: Update on STOP CRC." Collaboratory Grand Rounds, Webinar, April 29, 2015.

Coronado GD, Green B. "How are Clinics doing it? A system-based approach to understanding variation in clinic workflows." Research to Reality Webinar, March 24, 2015.

Coronado GD, Retecki S, Schneider J, Taplin S, Burdick T, Green BB. "Recruiting Community Health Centers Into Pragmatic Research: Mixed-Methods Findings from STOP CRC." HMORN Long Beach, CA, March 10-11, 2015.

Coronado GD, Petrik AF, Schneider J, Siebel E, Green B, Rivelli J. "Using Plan-Do-Study-Act Cycles to Adapt Interventions in Learning Health Systems." HMORN Conference, Long Beach, CA, March 10-11, 2015

Coronado GD, Green BB. "Colorectal cancer screening in primary care: Update on STOP CRC." Grand Round presentation for the NIH Collaboratory. November 7, 2014 (webinar).

Coronado G, Vollmer WM, Petrik A, Aguirre J, Kapka T, Oluloro A, Sanchez J, Burdick T, Green B. "Adapting Innovations for Safety Net Practices: Strategies and Opportunities to STOP Colon Cancer in Priority Populations." American Public Health Association Annual Meeting and Exposition, New Orleans, LA, November 19, 2014.

Puro J, Coronado G, Petrik A, Aguirre J, Kapka T, Green B, Le T, Burdick T. “Using EHR Data to Automate Colorectal Cancer Screening at Community Health Centers: Opportunities and Barriers.” AMIA Annual Symposium, Washington, DC, November 15-19, 2014.

Vollmer WM. "Pragmatic Solutions for Pragmatic Problems: Examples from the STOP CRC Trial." 1st Seattle Symposium on Healthcare Data Analytics: Confronting Statistical Challenges of Using Electronic Health Record Data to Conduct Health Research, Seattle, WA, September 29, 2014.

 

Burdick T. "Clinical Decision Support for Research- It's Not Just Pop-ups Anymore!" NIH Collaboratory Grand Rounds, September 26, 2014.

Coronado GD, Green BB. "Addressing colorectal cancer screening in community health centers: STOP CRC." Presentation to FIGHT Colon Cancer. September 16, 2014, (webinar).

Coronado GD, Green BB. "Addressing colorectal cancer screening in community health centers: STOP CRC." Presentation to the ARC NW CDC project officers. June 19, 2014, Seattle, WA.

Coronado GD. “Oregon’s Health Care Transformation and Latino Health Equity.” Plenary Session for the Latino Health Equity Conference, Portland, OR, June 13, 2014.

Coronado GD, Schneider J, Sanchez J, Petrik A, Green B, Oluloro A. “Reasons for non-response to a direct-mailed FIT kit program: Lessons learned from a pragmatic colorectal-cancer screening study in a Federally Sponsored Health Center.” Latino Health Equity Conference, Portland, OR, June 13, 2014.

Coronado GD, Schneider J, Sanchez J, Petrik A, Green B. “Using Videos to Activate and Inform Latino Patients about Colorectal Cancer Screening.” Latino Health Equity Conference, Portland, OR, June 13, 2014.

Coronado GD, Burdick T, Petrik A, Kapka T, Retecki S, Sumic A, Green B. “Using an automated data-driven, EHR-embedded program for mailing FIT kits: Lessons from the STOP CRC pilot study.” Latino Health Equity Conference, Portland, OR, June 13, 2014.

Coronado GD. "Cancer screening transformation in primary care: STOP CRC." Presentation to the Quality Improvement Meeting of the Washington State Community and Migrant Health Centers. June 9, 2014, Wenatchee, WA.

Coronado GD, Schneider J, Sanchez J, Petrik A, Green B. “Reasons for non-response to a direct-mailed FIT kit program: Lessons learned from a pragmatic colorectal-cancer screening study in a Federally Sponsored Health Center.” HMORN Conference, Phoenix, AZ, April 1-3, 2014.

Coronado GD, Vollmer WM, Petrik A, Sanchez J, Schneider J, Retecki S, Meenan R, Burdick T, Puro J, Kapka T, Aguirre J, Miers T, Turner A, Green B. “Preventing colon cancer in safety net clinics: STOP CRC.” HMORN Conference, Phoenix, AZ, April 1-3, 2014.

Coronado GD, Vollmer WM, Petrik A, Aguirre J, Kapka T, DeVoe J, Puro J, Miers T, Lembach J, Turner A, Sanchez J, Retecki S, Nelson C, Green B. "Strategies and Opportunities to STOP Colon Cancer in Priority Populations: STOP CRC Pragmatic Pilot Study Design and Outcomes." HMORN Conference, Phoenix, AZ, April 1-3, 2014.

Coronado GD, Green BB. "Successful practices to increase CRC screening: STOP CRC." Presentation to the Medical Directors of the Coordinated Care Organizations. May 12, 2014, Salem, OR.

Coronado GD, Petrik AF, Spofford M, Retecki S, DeVoe J. "Strategies and opportunities to STOP colon cancer in priority populations: Pragmatic study design and methods." 19th Annual HMORN Conference. April 2013, San Francisco, CA.

Coronado GD, Vollmer B, Green B. "Statistical Considerations for STOP CRC." Health Systems Collaboratory Steering Committee Meeting, Washington, DC, April 2013.

Coronado GD, Green B, DeVoe J. "STOP CRC Strategies and Opportunities to STOP Colorectal Cancer in Priority Populations." Washington University. St. Louis, MO, November 7th, 2012.