Preferred Name
Sarah E.M. Stowell
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
ORCID
https://orcid.org/0009-0005-8182-3467
Date of Graduation
12-14-2023
Semester of Graduation
Fall
Degree Name
Doctor of Nursing Practice (DNP)
Department
School of Nursing
First Advisor
Erika Metzler-Sawin
Second Advisor
David Switzer
Third Advisor
Amy Graham
Fourth Advisor
Jeannie Corey
Abstract
Background: Despite low-cost and effective screening tools, colorectal cancer (CRC) mortality remains high in the U.S., particularly in rural areas like Virginia’s Northern Shenandoah Valley, where screening rates are low. While literature highlights barriers to CRC screening in these communities and suggests improvement strategies, few studies focus on long-term adherence to screening in rural health clinics (RHCs).
Purpose: This program evaluation assessed the impact and effectiveness of the Rural Colorectal Cancer Rescreening Initiative (RCRI), a pilot program to increase colorectal cancer rescreening rates in a local RHC. It also offers recommendations for optimizing future RCRI efforts. Methods: The program evaluation used the PRECEDE-PROCEED model (PPM) to assess the planning, implementation, and evaluation of the RCRI pilot. Data to evaluate program outcomes was collected using direct observation and retrospective electronic health records (EHR) review. Results: The program evaluation yielded valuable formative feedback regarding the program’s design, quality, and sustainability; however, several barriers, such as suboptimal staff participation, contextual influences, and leadership support, negatively impacted objective achievement.
Conclusion: The findings highlighted the need for improved planning processes, stakeholder engagement, enhanced documentation practices, cost-effective and sustainable solutions to data management and risk assessment, embedded program champions, and the potential for a dedicated nurse navigator to improve preventive care adherence.
Keywords: colorectal cancer, screening, rescreening, longitudinal adherence, preventative care, program evaluation, quality improvement, advanced notifications, direct mail, multitarget stool DNA, fecal immunochemical tests, rural health clinic
Included in
Digestive System Diseases Commons, Family Medicine Commons, Gastroenterology Commons, Other Medical Sciences Commons, Preventive Medicine Commons, Primary Care Commons
