With 56% of colorectal cancer (CRC) diagnosed in advanced stages, Virginia remains one of the top three CRC mortality hotspots in the US. The same is true for cervical cancer (CCa), with a 48% diagnosed in advanced stages. Therefore, we propose to implement a quality improvement initiative at five Care Centers (FQHCs) in south central Virginia to identify systemic barriers and address race-related barriers to screening and diagnostic follow-up. CRC and CCa using evidence-based approaches. Uniquely, we propose that Care Centers (FQHCs) work in partnership with local community organizations to elevate community voice, increase support, acceptance and sustainability of the implemented intervention.

The goals are to increase screening by 5-10%, improve diagnostic follow-up processes, increase provider and community knowledge of cancer screening, and create parallel partnerships that support health initiatives. of cancer beyond the deadline and continue with this project.

OBJECTIVES: The objectives of the COALESCE Project are:

1. Increase CRC and CCa screening by 5-10% at each FQHC.

2. Improve diagnostic monitoring processes.

3. Increase provider and community knowledge about cancer screening.

4. Build parallel partnerships that support cancer health initiatives beyond the deadline and continue this project.

FQHC-Community dyads will come together to address systemic barriers to cancer screening through the following goals:

1. Implement and disseminate the adapted intervention, with the participation of the community.

2. Associate, to increase acceptance, trust and engagement in the broader community. Exceptionally, this will be done jointly, as a dyad (FQHC-community organisation). The VCU team will be involved throughout this iterative process through regular contact with assigned project site leads (VCU) and the provision of training and support.

Evaluate: Evaluate using a series of quantitative and qualitative metrics to determine the success of the project. The following 3 general measures will be evaluated:

1. Increase CRC and CCa screening rates for patients/clients of all participating FQHCs over the project period (see rationale in the “Assessment of Need” section).

2. Increase awareness of screening guidelines and systemic barriers to cancer screening among FQHC clinical and non-clinical staff as well as community organizations.

3. Improve/simplify cancer screening referral and diagnosis follow-up processes.