Table 3.

Training and education implementation strategies for ACCSIS patient navigation programs^a

Characteristics	Appalachia	Arizona	Chicago	New Mexico	North Carolina	Oklahoma	Oregon	San Diego
Training and education implementation strategy
Patient navigation training topics	Voluntary self-directed web-based training https://www.cecentral.com/node/1466 with continuing education credits Informal training delivered during implementation planning, clinic orientation, and on-the- job training	9 modules (M) M1: CRC 101 M2: Epidemiology of CRC among AI M3: CRC screening guidelines M4: Stool-based CRC screening tests M5: Direct visualization CRC screening tests M6: CRC risk factors M7: CRC diagnosis and treatment M8: Stages of change and motivational interviewing M9: Patient navigation tips; Initial navigator training conducted in partnership with NM and OK; AZ-specific training addressed data tracking	3 modules M1: CRC screening and surveillance:1 h M2: social needs assessment and patient education skills:1 h M3: intake process and available resources:1 h	Same 9 modules as AZ	Self-directed training using navigation toolkit (Lynn Butterly) and other web-based modules; webinars on effective patient navigation; motivational interviewing training	Same 9 modules as AZ	4-module core training program: M1: Patient navigation and colon health (pre-recorded videos): 1 h M2: Effective messages and script review (interactive virtual class): 1.5 h M3: Practice (interactive virtual class): 1.5 h M4: Data tracking (webinar): 1 h Optional module: motivational interviewing (prerecorded videos): 1 h	Review of ACCISS protocol via videoconference (using handouts): 1.5 h Review of data materials: 1 h Booster sessions as needed
Training time	1 h plus online	2 d plus 6 h	3 h	2.5 d	Variable	2.5 d	4 h core/1 h optional	2.5 h/additional as needed
Training format	In-person or videoconference, and online	In-person	Videoconference	In-person	Toolkit review and web-based modules	In-person	Pre-recorded videos, live video-conference; training materials and evaluations hosted on learning management system	Video-conference
Refresher training format	Uses training materials and 1-on-1 assistance by study staff	Half-day session held virtually or in-person	Ongoing 20-min booster training during routine care management team meetings; providers are reminded to tell their patients receiving FIT that they will be enrolled in a text messaging platform	Refresher trainings in community or clinic-based settings, ranging from 2 h (in-person) to half-day (webinar)	Meetings with patient navigation workgroup, physician consultation available (including GI) at cancer center; consultation with clinic providers and medical directors as needed; periodic consultation with PNs from other institutions	2 half-day sessions; initially in person but shifted to virtual format post-COVID	Meetings held with Medicaid health plan staff, clinic staff (including PNs), and research team; 1-on-1 support available from practice facilitators; PNs can access asynchronous training videos as needed on learning management system	Health Quality Partners provides technical assistance and responds to inquiries via email
Refresher training frequency	As needed	Annual	Every 4 mo	3/y	Weekly/as needed	As needed	Monthly learning collaboratives, asynchronous training videos, ad hoc practice facilitation	Bi-weekly/as needed

^aACCSIS = Accelerating Colorectal Cancer Screening and Follow-Up Through Implementation Science; M = module; CRC = colorectal cancer; AI = American Indian; FIT = fecal immunochemical test; GI = gastroenterology; PN = patient navigator.