Town Hall on Health Policy and Health Equity for Local Populations

Colorectal cancer (CRC) screening can reduce morbidity and mortality but is underused, particularly among low-income and some minoritized populations. Mailed fecal immunochemical testing (FIT) is an evidence-based strategy to increase colorectal cancer (CRC) screening. We tested a multi-level mailed FIT intervention in 3 community health center (CHC) systems in San Diego County using a cluster-randomized trial design. Multi-level implementation strategies were utilized to increase CRC screening uptake. Among 26,736 participants who met eligibility criteria, approximately 58% were female, 55% were Hispanic individuals, and 44% were Spanish speaking. The proportion completing screening was 11.5 percentage points (ppts) (95% CI, 6.1–16.9 ppts) higher in intervention versus usual care clinics. Variation in differences between intervention and usual care clinics was observed by racial and ethnic group (13.8 ppts [7.0–20.6 ppts] for Hispanics; 13.0 ppts [3.6–22.4 ppts] for Asians; 11.3 ppts [5.8–16.8 ppts] for non‐Hispanic Whites; 6.1 ppts [0.8–10.4 ppts] for Blacks). These results show that a regional mailed FIT intervention was effective for increasing CRC screening rates across CHC systems serving diverse, low‐income populations.  

The population is rapidly aging, with older adults expected to outnumber children in the coming decades. Concomitantly, many older adults are living longer with major chronic diseases of aging and with diminishing resources to address their housing and healthcare needs. The purpose of this presentation is to present a collaboration between St. Paul Senior Services and UCSD School of Public Health to deliver a comprehensive healthcare intervention in the primary care setting to reduce healthcare costs and improve health outcomes in older adults at risk of nursing home admission and homelessness.