CPCRN Network Center:

Comprehensive Cancer Control Collaborative of North Carolina

University of North Carolina at Chapel HillAtlanta, GA

October 15, 2009

4CNC at UNC-Chapel Hill

• Center for Health Promotion Disease Prevention

• Lineberger Comprehensive Cancer Center is a key partner

Advisory GroupAlice Ammerman Marci Campbell Laura LinnanSally Malek Deb Mayer Michael O’MalleyMichael Pignone Barbara Rimer Walter Shepherd

Pam Silberman

InvestigatorsNoel BrewerBill Carpenter

Jennifer LeemanKurt Ribisl

Research and Practice Team

Principal InvestigatorCathy Melvin

Training / TAMonair Hamilton

Project DirectorAlexis Moore

Program AssistantXavier McCutcheon

•Aim 1: Maintain and enhance existing 4CNC infrastructure: Further develop local and CPCRN partnerships Identify and rapidly respond to priority areas, emerging

issues Initiate and support CPC,

dissemination and implementation research, and evidence-informed practice

Disseminate 4CNC products and results

Infrastructure Services

• Aim 2: Advance the science and practice of dissemination and implementation across the cancer continuum with a focus on: Promote HPV vaccine use Eliminate disparities in breast cancer

screening and treatment Prevent initiation and increase cessation of

tobacco use Increase CRC screening (proposed cross-

center project)

Cancer Focus

• Aim 3. Support and inform implementation of Community Guide recommendations to increase CRC screening Increase provider use of decision

support for CRC screening Special emphasis on increasing use

among minority and uninsured individuals

Cross-Center Collaboration

Statewide Summit

Partner meetings and site visits

CRC Screening Consortium:High Point, NC

Safety Net

NC Community Health Center Association

Provider recommendation and referral

Multi-state Task Force to develop a CRC communications campaign for rural states

CRC screening program for uninsured

Community engaged to plan EBI adoption

Provider education and academic detailing

Godley. Improving CRC Screening: Enhancing Systems …. NCI

Melvin. Increasing Early Detection of CRC: Enhancing … Access to Care. LCCC

• Campbell. ACTS of Wellness. CDC. Implementing 4CNC’s small media component

Cross-center project

Implement process to

create strong collaboration

Provide education and

support for participatory

program planning

Use promising

dissemination strategies

Implementation &

Dissemination Research

Small media

Dissemination and Implementation Activities to Improve CRC Screening

AIMS1. Assess current use of decision aids in

different settings (including states with and without programs to support CRC screening)

2. Explore individual and systems barriers to provider recommendation and referral

3. Update decision support tools based on most recent recommendations

Proposed Cross Center Project

AIMS (cont)4. Modify decision aids based on patient

preferences and perceptions about CRC screening

5. Identify approaches to increase screening referrals in minority and underserved communities

6. Conduct Dissemination and Implementation research to promote decision aid use and achieve changes in CRC practice

Proposed Cross Center Project

Methods• Cross-center formative research to develop

instruments for assessing current use of, and patient response to decision aids for CRC; and to identify and understand individual and systems barriers

• Initial work at UNC among FQHCs to develop and test chart review and focus group guides

Proposed Cross Center Project

Cross-Center Collaboration

• Form working group to – Participate in formative research tool development and

testing– Conduct formative research in practice settings or

among populations of interest to each center– Participate in data analysis and reporting– Interpret findings for studies of how best to influence

provider uptake and use of decision support tools and materials

Proposed Cross Center Project

Anticipated Products• Assessment tools

– Provider– Patient

• Design and Implementation of Surveys– Manuscripts‘– Preliminary findings section for follow-on

proposals• Updated decision support tools and materials• Follow-on proposals

Proposed Cross Center Project

CPCRN Grantees Meeting

Atlanta, GAOctober 15-16, 2009