Concerns about the cost of testing or follow up care for uninsured patients
Costs for uninsured patients hinder sustainability; the new fecal screening test is more costly than the old one. Community resources for colonoscopy are limited/variable and/or enrollment paperwork is burdensome.
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Yes |
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Concerns about clinic capacity
Limited capacity of clinic staff; teams have already set priorities for the year; Leadership/ staff turnover may lessen project emphasis or limit needed resources; Challenges to standardizing use of new fecal screening test; colonoscopy perceived as a better test or “community standard of care”; Some clinics may require extra effort; some have limited change capacity, are geographically remote, serve many uninsured patients, or have few available colonoscopy resources;
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Yes
Yes
Yes |
Competing priorities
Launching other initiatives; opening a new clinic; Upcoming EHR upgrade will require additional staff time; Need time to plan a comprehensive prevention strategy that will include STOP CRC screening; Existing CRC screening programs/plans are underway and perceived as incongruous with proposed program.
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Yes
Yes
Yes |
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Concerns with randomization of clinics
Hinders health centers’ mission to provide equal treatment/ access to all patients; Maintaining usual care in some sites is perceived as being “held back”; need to demonstrate rapid improvement in CRC screening rates; Phased approach (starting with intervention clinics) may require too much effort or be inconsistent with clinic readiness and capacity.
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Yes |
Concerns proposed program will not work
Proposed program may be ill suited for unique clinic settings; Mailed approach may have limited success given high rates of incorrect addresses; Already have high rates of CRC screening; additional efforts may be unnecessary.
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Yes
Yes |
