The comprehensive analysis of the causal loop diagram reveals several key insights and recommendations for clinics aiming to enhance colorectal cancer (CRC) screening through evidence-based interventions (EBIs). By understanding the interconnected factors that influence screening modality and EBI selection, clinics can take strategic actions to improve their screening programs.

Here are some high-level recommendations:

• Invest in Patient Navigation Services: Support patients in addressing potential barriers to completion of routine and diagnostic colonoscopies by implementing patient navigation.
• Develop and Strengthen Connections and Partnerships with Endoscopy Providers: Facilitate smooth pathways to colonoscopy completion through establishing partnerships with endoscopy providers.
• Consider Short-Term and Long-Term Screening Adherence in Decision-Making: Select CRC screening modalities and EBIs to support those modalities with both annual and long-term (e.g., 10 years) screening completion in mind. Consider the likelihood that patients will be able to complete year-to-year stool-based testing when making recommendations about modality type.

By integrating these recommendations, clinics can enhance their capacity to improve adherence to high-quality screening, ultimately preventing CRC cancer cases and improving population health outcomes.