What impacts a clinic's ability to select and adapt EBIs impact?
Increasing a clinic’s ability to select and adapt EBIs that in combination meet their specific needs, increases the clinic’s capacity to strengthen their EBI approach over time. This happens because if a clinic selects the best suited EBIs initially, the EBIs are more likely to be effective and only require moderate changes over time. Similarly, selecting and adapting the most appropriate and best fit EBIs initially, and then strengthening them over time as necessary, increases the extent to which EBIs can address multilevel success factors.
A clinic’s capacity for systems thinking is also important to consider. Systems thinking capacity increases the overall understanding of factors that influence CRC screening in the context of a specific clinic, which allows the clinic to select the most suitable EBIs. An increased understanding of the system also helps the clinic to better strengthen EBIs over time and adapt EBIs to better match their needs. Adapting EBIs to better match the needs of a specific population, increases the extent to which the EBIs can address multilevel success factors.[[195, 198, 318, 323]]
Cited references for this diagram
Second, each EBI was modified to fit the needs and staffing model for this health system, which may have improved efficiency and impact.
Kim KE, Tangka FKL, Jayaprakash M, Randal FT, Lam H, Freedman D, Carrier LA, Sargant C, Maene C, Hoover S, Joseph D, French C, Subramanian S. Effectiveness and Cost of Implementing Evidence-Based Interventions to Increase Colorectal Cancer Screening Among an Underserved Population in Chicago. Health Promot Pract. 2020 Nov;21(6):884-890. doi: 10.1177/1524839920954162. Epub 2020 Sep 29. PMID: 32990041; PMCID: PMC7894065.
This study demonstrates that EBIs to increase CRC screening may be effective in clinics with fewer resources that serve populations who have poor access to or under-utilize health care services. Tailoring the EBIs to the needs and capacity of participating clinics may have been key to their effectiveness.
Kim KE, Tangka FKL, Jayaprakash M, Randal FT, Lam H, Freedman D, Carrier LA, Sargant C, Maene C, Hoover S, Joseph D, French C, Subramanian S. Effectiveness and Cost of Implementing Evidence-Based Interventions to Increase Colorectal Cancer Screening Among an Underserved Population in Chicago. Health Promot Pract. 2020 Nov;21(6):884-890. doi: 10.1177/1524839920954162. Epub 2020 Sep 29. PMID: 32990041; PMCID: PMC7894065.
The EBIs used in the CRCCP can be implemented differently, and practitioners can benefit from ensuring that the interventions are appropriate for their unique clinic population and context.
Sharma KP, Leadbetter S, DeGroff A. Characterizing clinics with differential changes in the screening rate in the Colorectal Cancer Control Program of the Centers for Disease Control and Prevention. Cancer. 2021 Apr 1;127(7):1049-1056. doi: 10.1002/cncr.33325. Epub 2020 Dec 10. PMID: 33301173; PMCID: PMC9242539.
The study findings support that clinics may choose to implement strategies best suited for their unique circumstances and availability of resources.
Sharma KP, DeGroff A, Maxwell AE, Cole AM, Escoffery NC, Hannon PA. Evidence-Based Interventions and Colorectal Cancer Screening Rates: The Colorectal Cancer Screening Program, 2015-2017. Am J Prev Med. 2021 Sep;61(3):402-409. doi: 10.1016/j.amepre.2021.03.002. Epub 2021 May 14. PMID: 33994253; PMCID: PMC11008572.
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