Date of Award
Spring 2026
Project Type
Clinical Doctorate
College or School
CHHS
Department
Nursing
Program or Major
Doctor of Nursing Practice (DNP)
Degree Name
Other
First Advisor
Dayle Sharp
Abstract
Abstract
Background: Colorectal cancer (CRC) is on the rise and is currently the second leading cause of cancer-related death in the United States (Wender, 2022). CRC screening rates are below national goals, particularly among underserved populations. At Lowell Community Health Center (LCHC), only 41.9% of eligible adults were up to date with CRC screening as of 2024.
Purpose: This quality improvement project aimed to increase CRC screening rates among average-risk adults aged 45 to 75 by implementing a multifaceted, low-burden intervention targeting both provider and patient behaviors.
Methods: Guided by the Plan-Do-Study-Act (PDSA) framework, the intervention included: (1) provider and clinical staff education on CRC screening and the option of Cologuard screening tests, and (2) patient-facing educational materials, including linguistically tailored videos and pamphlets. Pre- and post-intervention data were collected via chart review over a two-month period, tracking CRC screening orders and 60-day completion rates. Statistical analysis included two-proportion z-tests to compare pre- and post-intervention outcomes.
Results: Among overdue patient visits without prior outstanding screening orders, CRC screening orders increased from 30.8% pre-intervention to 40.2% post-intervention, a statistically significant change (p = 0.002). Overall, 60-day completion rates showed no significant change, from 47.9% pre-intervention to 43.4% post-intervention (p = 0.455). Specific stool-based test completion rates for Cologuard and FIT did not significantly change either.
Conclusions: The intervention successfully improved provider ordering behavior but did not significantly impact patient completion within 60 days. Findings suggest that addressing structural and patient-level barriers, in addition to provider education, may be necessary to increase overall CRC screening completion rates.
Recommended Citation
McPhee, Kaeli H., "Increasing Colorectal Cancer Screening Rates at a Federally Qualified Health Center: A Quality Improvement Project" (2026). DNP Scholarly Projects. 140.
https://scholars.unh.edu/scholarly_projects/140