Date of Award
Spring 2026
Project Type
Clinical Doctorate
College or School
CHHS
Department
Nursing
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