Accelerating Colorectal Cancer Screening and follow-up through Implementation Science (ACCSIS)

ACCSIS Overview

ACCSIS is improving colorectal cancer screening, follow-up, and referral for care among populations that have low colorectal cancer screening rates. ACCSIS focuses on underserved groups in particular, including racial and ethnic minority populations and people living in rural or difficult-to-reach areas.

The two-phase projects in this program are designing multilevel interventions that increase colorectal cancer screening and healthcare delivery, as well as developing guidelines for scaling-up and implementing these multilevel interventions to reduce the burden of colorectal cancer. The first phase of these projects focuses on pilot studies that demonstrate the feasibility and potential effectiveness of multilevel interventions at increasing colorectal cancer screening and follow-up. The second phase involves testing the implementation and impact of the multilevel interventions in target populations with low colorectal cancer screening rates.

For more information about ACCSIS, please visit their website.

ACCSIS Centers

The ACCSIS Program is comprised of one Coordinating Center and three Research Centers. The Coordinating Center supports organizational, administrative, scientific activities of the Program. The Research Centers develop and implement multilevel interventions.

Overview of Projects

ACCSIS Coordinating Center

The Coordinating Center (CC) focuses on internal and external operations of the network. Internally, the CC provides logistical support to ensure productive interactions between the NCI program staff, research project awardees, the CC, and members of the ACCSIS Steering Committee and work groups. Externally, the CC provides the platform and develops processes to share ACCSIS consortium activities and results with stakeholders including policy makers, implementers at the state and local levels, and other researchers.

ACCSIS Research Centers

• ACCSIS - Appalachia: The investigators proposed to examine the impact of a multilevel intervention, using a delayed randomized controlled trial, on improving colorectal cancer outcomes among Appalachian populations in Kentucky and Ohio. The intervention consists of academic detailing, patient activation to include distribution of fecal immunochemical tests kits, and social support via a patient navigator.
• ACCSIS – Chicago: The investigators proposed a two-phase study to pilot test, refine, and evaluate the effectiveness of a multilevel intervention to improve colorectal cancer incidence and mortality outcomes among at-risk populations attending safety-net clinics in Cook County and Chicago, Illinois. The intervention, targeting the individual, clinic, community, and organizational levels, consists of provider education; community outreach; a provider reminder; assessment and feedback system; and patient navigation.
• ACCSIS – North Carolina: The investigators proposed a pragmatic randomized controlled trial to assess the effectiveness of a multilevel intervention to improve colorectal cancer outcomes among low-income and racial and ethnic minority populations in North Carolina. Guided by the Capability-Opportunity-Motivation Behavior System, the intervention consists of a centralized colorectal cancer screening registry, distribution of fecal immunochemical test kits, patient navigation, an in-clinic patient decision aid, and establishing a colonoscopy access network.
• ACCSIS - Oregon: The investigators proposed a two-phase project that is designed to achieve the Cancer Moonshot objectives by reducing the burden of CRC on the US population. Specifically, they seek to improve CRC screening rates, follow-up colonoscopy, and referral to care in rural Medicaid patients by implementing a direct mail fecal testing program with targeted outreach and patient navigation for follow-up colonoscopy. In SMARTER CRC, the multidisciplinary team will adapt, pilot, then test the implementation and scale-up of targeted direct-mail and patient navigation programs – two effective multicomponent interventions – in partnership with rural clinics, health plans (payers), and commercial vendors. The investigator’s approach leverages an established rural practice-based research network; addresses patient, clinic, and community level factors; and will ultimately reduce CRC disparities in rural Medicaid patients and support Biden's Cancer Moonshot objectives.
• ACCIS - San Diego: The investigators proposed a two-phase study to pilot and optimize and rigorously test he Hub and Spoke approach and its impact on CRC screening, follow-up, and usual care. The intervention includes HQP hub-based delivery of centralized mailed FIT to patients served by individual CHCs-spokes plus complimentary provider and clinic-level interventions at CHCs, and coordination of a standardized navigation strategy delivered by CHCs for abnormal FIT follow-up. The overarching hypothesis is that a Hub-and-Spoke multilevel intervention that combines centralized strategies implemented or coordinated by an umbrella CHC organization (hub) to regional CHCs (spokes) and their patients is an effective, scalable, and sustainable approach to optimize CRC screening, follow-up, and referral- to-care regionally.

NCI ACCSIS Staff

• Sarah Kobrin: Program Director/Lead
• Wynne Norton: Project Scientist
• Genevieve Grimes: Administrative Program Director