Table 2.

Key quotes on FQHC priorities and barriers and facilitators to cancer prevention

Topic	Key theme	Quotes
FQHC priorities	Current top external priorities for FQHCs are PCMH transformation and EHR implementation.	“I think it’s just keeping our heads above water in the pace of this change that is the priority.” “The highest priority for assisting FQHCs is really with the transformation taking place in healthcare, specifically the PCMH.”
	Top internal priorities are diabetes and sustaining basic resources.	“Diabetes is always one that we focus on.” “In the food chain, the first priority is keeping the lights on.”
Barriers to cancer prevention in FQHCS	Competing priorities amidst health care reform and scarce time and resources are barriers in FQHCs.	“I think that everyone feels really just overwhelmed with the number of demands on their time.”
	Patient insurance status is a primary barrier in FQHC populations.	“In a population of patients with no health coverage, preventative care for the family usually takes a low priority.”
	FQHCs named lack of reimbursement as a barrier to lifestyle-related prevention.	“We’re living in a very encounter-based reimbursement scheme. A cooking or exercise class… we’re having to figure out how to fund that on a shoestring.”
Facilitators to cancer prevention in FQHCs	FQHCs and PCAs thought of cancer prevention in terms of the UDS outcome measures they report to HRSA.	"When HRSA says that we all have to do it, we all do it." “A lot of our numbers are being driven by meaningful use or UDS measures.”
	Urban FQHCs named patient navigators or health coaches as a facilitator to cancer prevention.	“We try to model our patient navigation concept with all of them [cancer screening, tobacco cessation, lifestyle-related prevention], because it has proven to be really successful.” “We can see where a coach can spend 15 to 20 min when the provider can’t as really being effective.”
	FQHCs in states with an active quit line named this as a facilitator to tobacco cessation.	“Our CHCs [FQHCs] are working very closely with the state quit line.” “I mean, the people use it [the quit line]. I’ve seen them using it. They come in and ask for it.”