ArticleImplementation science communications2021
What's the "secret sauce"? How implementation variation affects the success of colorectal cancer screening outreach.
Article in Implementation science communications, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
28 citing papers in PubMed.
- The difference-making role of staff support in implementing nurse care management for opioid use disorder treatment: A configurational analysis.Journal of substance use and addiction treatment · 2025Trial
- Community organization capacity and barriers to mental health promotion efforts: a configurational analysis.BMC public health · 2026Article
- How segregation, low birth weight, unemployment, and violence link to low life expectancy in Chicago.Health affairs scholar · 2026Article
- Difference-Making Factors Linked to Higher Reach of Specialist Palliative Care Among People With Heart Failure Across a National Sample of VA Medical Centers.The American journal of hospice & palliative care · 2025Article
- Methodological recommendations for assessing the impact of adaptations on outcomes in implementation research.Implementation science : IS · 2025Article
- Adapting Public Health and Health Services Interventions in Diverse, Real-World Settings: Documentation and Iterative Guidance of Adaptations.Annual review of public health · 2025Review
- Difference-making factors for successful implementation of a multicomponent colorectal cancer screening program in rural clinics (SMARTER CRC).Frontiers in medicine · 2025Article
- Feasibility and efficacy of a novel audiovisual tool to increase colorectal cancer screening among rural Appalachian Kentucky adults.Frontiers in public health · 2024Article
- Mail-Based Self-Sampling to Complete Colorectal Cancer Screening: Accelerating Colorectal Cancer Screening and Follow-up Through Implementation Science.Preventing chronic disease · 2023Article
- The role of organizational capacity in intervention efficacy in a church-based cancer education program: A configurational analysis.Global implementation research and applications · 2023Article
- How does facilitation in healthcare work? Using mechanism mapping to illuminate the black box of a meta-implementation strategy.Implementation science communications · 2023Article
- Implementing organized colorectal cancer screening programs in Europe-protocol for a systematic review of determinants and strategies.Systematic reviews · 2023Article
- Improving colorectal cancer screening in rural primary care: Preliminary effectiveness and implementation of a collaborative mailed fecal immunochemical test pilot.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2023Article
- Determinants of inter-organizational implementation success: A mixed-methods evaluation of Veteran Directed Care.Healthcare (Amsterdam, Netherlands) · 2022Article
- Assessing the impact of multicomponent interventions on colorectal cancer screening through simulation: What would it take to reach national screening targets in North Carolina?Preventive medicine · 2022Article
- Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers.Implementation science communications · 2022Article
- Core implementation strategies for improving cirrhosis care in the Veterans Health Administration.Hepatology (Baltimore, Md.) · 2022Article
- Observational
- How education and racial segregation intersect in neighborhoods with persistently low COVID-19 vaccination rates in Philadelphia.BMC public health · 2022Article
- Mailed fecal testing and patient navigation versus usual care to improve rates of colorectal cancer screening and follow-up colonoscopy in rural Medicaid enrollees: a cluster-randomized controlled trial.Implementation science communications · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
backgroundMailed fecal immunochemical testing (FIT) programs can improve colorectal cancer (CRC) screening rates, but health systems vary how they implement (i.e., adapt) these programs for their organizations. A health insurance plan implemented a mailed FIT program (named BeneFIT), and participating health systems could adapt the program. This multi-method study explored which program adaptations might have resulted in higher screening rates.
methodsFirst, we conducted a descriptive analysis of CRC screening rates by key health system characteristics and program adaptations. Second, we generated an overall model by fitting a weighted regression line to our data. Third, we applied Configurational Comparative Methods (CCMs) to determine how combinations of conditions were linked to higher screening rates. The main outcome measure was CRC screening rates.
resultsSeventeen health systems took part in at least 1 year of BeneFIT. The overall screening completion rate was 20% (4-28%) in year 1 and 25% (12-35%) in year 2 of the program. Health systems that used two or more adaptations had higher screening rates, and no single adaptation clearly led to higher screening rates. In year 1, small systems, with just one clinic, that used phone reminders (n = 2) met the implementation success threshold (≥ 19% screening rate) while systems with > 1 clinic were successful when offering a patient incentive (n = 4), scrubbing mailing lists (n = 4), or allowing mailed FIT returns with no other adaptations (n = 1). In year 2, larger systems with 2-4 clinics were successful with a phone reminder (n = 4) or a patient incentive (n = 3). Of the 10 systems that implemented BeneFIT in both years, seven improved their CRC screening rates in year 2.
conclusionsHealth systems can choose among many adaptations and successfully implement a health plan's mailed FIT program. Different combinations of adaptations led to success with health system size emerging as an important contextual factor.
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