Pilot Implementation of the Flu-FIT Program

Introduction The primary goal of this project is to determine if the Flu-FIT program could serve as an effective way to increase compliance with colorectal cancer screening guidelines among low-income and uninsured residents of Utah County. Problem Statement The U.S. Preventative Services Task Force (USPSTF) recommends that all average-risk people between age 50 and 75 years be screened for colorectal cancer. The American Cancer Society has expressed a goal to have 75% of Americans age 50-75 years up-to-date with colorectal cancer screening guidelines by 2015 (Potter et al., 2011, p. 577). In Utah County, only 63% of residents are current on colorectal cancer screening. Colorectal cancer screening rates among low-income and uninsured residents of Utah County are even lower. Objectives 1-Collaborate with leaders at the Utah County Health Department to develop an implementation plan for a pilot test of the Flu-FIT program targeting low income and or uninsured residents of Utah County. 2-Identify a low-income and/or uninsured population to participate in the pilot program. 3-Evaluate the participation in the pilot program targeting low-income and uninsured residents of Utah County. 4-Disseminate findings of the pilot program to leaders at the Utah County Health Department as well as the Utah Cancer Control Program. Brief Literature Review Colorectal cancer is the second leading cause of cancer-related deaths in Utah (IBIS-PH, 2013). Colorectal cancer morbidity and mortality can be significantly reduced with effective screening practices. In fact, USPSTF estimates that attainment of the American Cancer Society's goal of 75% of the population up to date on colorectal cancer screening could save nearly 19,000 lives per year in the U.S. (USPSTF, 2008, p. 628). The Flu-FIT program is designed to combine annual fecal occult blood testing with annual flu shot clinics. This program, designed by colorectal cancer experts at the American Cancer Society, has been shown to be an effective method to increase colorectal cancer screening (Potter, 2011, p. 577) and may be "a particularly effective way to reach patients who are not gaining access to colorectal cancer screening through other methods" (Potter et al., 2013, p. 1132). Brief Implementation and Evaluation Plan Free take-home immunochemical fecal occult blood test kits were distributed to eligible patients when they came for their annual flu shot. The percentage of patients who were interested in participating and the percentage of interested that were eligible were calculated. These numbers were used to assess interest in the program as well as whether the program targets the correct population. Additionally, the return rate of the FIT kits was calculated to assess patient compliance. Summary There exists a need in Utah County for cost-effective colorectal cancer screening programs with the ability to reach low-income and uninsured residents. The Utah County Health Department holds annual flu shot clinics that reach hundreds of low-income and underinsured residents of Utah County each week during flu season. These clinics may provide an opportunity to reach the low-income residents of Utah County that are overdue for colorectal cancer screening. The Flu-FIT program may be an effective strategy to increase colorectal cancer screening among low-income and uninsured residents of Utah County.