Publications (2)3.64 Total impact
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Article: Start-up of the colorectal cancer screening demonstration program.
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ABSTRACT: In 2005, the Centers for Disease Control and Prevention funded five sites to implement the Colorectal Cancer Screening Demonstration Program (CRCSDP). An evaluation is being conducted that includes a multiple case study. Case study results for the start-up period, the time between initial funding and screening initiation, provide details about the program models and start-up process and reveal important lessons learned. The multiple case study includes all five CRCSDP sites, each representing a unique case. Data were collected from August 2005 through September 2006 from documents, observations, and more than 70 interviews with program staff and stakeholders. Sites differed by geographic service area, screening modality selected, and service delivery structure. Program models were influenced by two factors: preexisting infrastructure and the need to adapt programs to fit local service delivery structures. Several sites modeled program components after their National Breast and Cervical Cancer Early Detection Program. Medical advisory boards convened by all sites provided clinical support for developing program policies and quality assurance plans. Partnerships with comprehensive cancer control programs facilitated access to financial and in-kind resources. The program models developed by the CRCSDP sites offer a range of prototypes. Case study results suggest benefits in employing a multidisciplinary staff team, assembling a medical advisory board, collaborating with local partners, using preexisting resources, designing programs that are easily incorporated into existing service delivery systems, and planning for adequate start-up time.Preventing chronic disease 05/2008; 5(2):A38. · 1.82 Impact Factor -
Article: Facilitators and challenges to start-up of the colorectal cancer screening demonstration program.
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ABSTRACT: The Centers for Disease Control and Prevention (CDC) funded the Colorectal Cancer Screening Demonstration Program in 2005. To assess the feasibility of providing community-based colorectal cancer screening, CDC is conducting a multiple-case study as part of a larger evaluation effort. This article highlights key facilitators and challenges common to the five programs studied during the start-up period. The multiple-case study that includes all five program sites is being conducted during the 3-year program as part of process evaluation efforts. Data collection for program start-up occurred during August 2005 through September 2006. Data include approximately 70 interviews with program staff and stakeholders, document review, and observations. Both case-specific and cross-case analyses were conducted. On the basis of the cross-case analysis, we identified four factors that facilitated program start-up and four factors that challenged program start-up. Facilitating factors included 1) pre-existing program infrastructure, 2) partnerships, 3) clinical expertise, and 4) program champions. Factors challenging program start-up included 1) contracts with endoscopists, 2) resources for treating medical complications of screening and for cancer treatment, 3) administrative barriers, and 4) resource limitations. Additionally, preplanning was critical, allowing programs to efficiently initiate activities once funds became available. The most important facilitator identified was the ability to build on pre-existing infrastructure, which provided experienced staff, partnerships, and provider relationships, as well as aided program integration with other chronic disease programs. Results also suggest that substantial planning and partnership development can begin before funds are secured to implement a colorectal cancer screening program.Preventing chronic disease 05/2008; 5(2):A39. · 1.82 Impact Factor
