A Process Evaluation of the Alaska Native Colorectal Cancer Family Outreach Program

• Published in: Health education & behavior 2016-02, Vol.43 (1), p.35-42
• Main Authors: Redwood, Diana, Provost, Ellen, Lopez, Ellen D. S., Skewes, Monica, Johnson, Rhonda, Christensen, Claudia, Sacco, Frank, Haverkamp, Donald
• Format: Article
• Language: English
• Subjects: Adult; Adult children; Alaska; Alaska Natives; At Risk Persons; Barriers; Cancer; Children; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - diagnosis; Computerized medical records; Coordination; Cultural Awareness; Cultural competence; Death; Death & dying; Early Detection of Cancer - methods; Electronic health records; Electronic medical records; Evaluation; Family; Family (Sociological Unit); Financing; Formative Evaluation; Grants; Health behavior; Health Promotion; Health Services, Indigenous; Humans; Incidence; Indigenous peoples; Inuits; Mass Screening; Medical electronics; Medical Evaluation; Medical records; Medical research; Medical screening; Minority & ethnic groups; Minority Groups; Native peoples; Navigation; Outreach Programs; Parents; Patient Navigation; Patients; Policy Formation; Prevention programs; Program Descriptions; Program Development; Program Evaluation; Quality control; Quality management; Records (Forms); Relatives; Reliance; Screening; Screening Tests; Semi Structured Interviews; Siblings; Stakeholders; Sustainability
• ISSN: 1090-1981; 1552-6127
• DOI: 10.1177/1090198115590781

This article presents the results of a process evaluation of the Alaska Native (AN) Colorectal Cancer (CRC) Family Outreach Program, which encourages CRC screening among AN first-degree relatives (i.e., parents, siblings, adult children; hereafter referred to as relatives) of CRC patients. Among AN people incidence and death rates from CRC are the highest of any ethnic/racial group in the United States. Relatives of CRC patients are at increased risk; however, CRC can be prevented and detected early through screening. The evaluation included key informant interviews (August to November 2012) with AN and non-AN stakeholders and program document review. Five key process evaluation components were identified: program formation, evolution, outreach responses, strengths, and barriers and challenges. Key themes included an incremental approach that led to a fully formed program and the need for dedicated, culturally competent patient navigation. Challenges included differing relatives’responses to screening outreach, health system data access and coordination, and the program impact of reliance on grant funding. This program evaluation indicated a need for more research into motivating patient screening behaviors, electronic medical records systems quality improvement projects, improved data-sharing protocols, and program sustainability planning to continue the dedicated efforts to promote screening in this increased risk population.