Practice adaptive reserve and colorectal cancer screening best practices at community health center clinics in 7 states

BACKGROUND Enhancing the capability of community health centers to implement best practices (BPs) may mitigate health disparities. This study investigated the association of practice adaptive reserve (PAR) with the implementation of patient‐centered medical home (PCMH) colorectal cancer (CRC) screen...

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Bibliographic Details
Published in:Cancer 2015-04, Vol.121 (8), p.1241-1248
Main Authors: Tu, Shin–Ping, Young, Vicki M., Coombs, Letoynia J., Williams, Rebecca S., Kegler, Michelle C., Kimura, Amanda T., Risendal, Betsy C., Friedman, Daniela B., Glenn, Beth A., Pfeiffer, Debbie J., Fernandez, Maria E.
Format: Article
Language:English
Subjects:
adaptive reserve
Adult
Aged
best practices
Colorectal Neoplasms - diagnosis
Community Health Centers
Data Collection
disparities
Early Detection of Cancer
Healthcare Disparities
Humans
implementation
Middle Aged
Practice Guidelines as Topic - standards
primary care
United States
Young Adult
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Summary:BACKGROUND Enhancing the capability of community health centers to implement best practices (BPs) may mitigate health disparities. This study investigated the association of practice adaptive reserve (PAR) with the implementation of patient‐centered medical home (PCMH) colorectal cancer (CRC) screening BPs at community health center clinics in 7 states. METHODS A convenience sample of clinic staff participated in a self‐administered, online survey. Eight PCMH CRC screening BPs were scored as a composite ranging from 0 to 32. The PAR composite score was scaled from 0 to 1 and then categorized into 3 levels. Multilevel analyses examined the relation between PAR and self‐reported implementation of PCMH BPs. RESULTS There were 296 respondents, and 59% reported 6 or more PCMH BPs at their clinics. The mean PAR score was 0.66 (standard deviation, 0.18), and the PCMH BP mean scores were significantly higher for respondents who reported higher clinic PAR categories. In comparison with the lowest PAR level, adjusted PCMH BP means were 25.0% higher at the middle PAR level (difference, 3.2; standard error, 1.3; t = 2.44; P = .015) and 63.2% higher at the highest PAR level (difference, 8.0; standard error, 1.9; t = 4.86; P 
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.29176