ASPO Abstracts
Health Equity and Access to the Health Care System in Minority and Rural Communities: Implementation of a Precision Population Health Strategy
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Purpose of the Study: Screen to Save (S2S) is an evidence-based national initiative recommended by the
Blue Ribbon Panel for the Cancer Moonshot and endorsed by the National Cancer Advisory Board to
increase colorectal cancer (CRC) screening rates in minority and rural areas. As part of the National
Outreach Network (NON) Community Health Educators (CHE), this study examined knowledge of CRC
screening guidelines and screening intent among high-risk populations.
Methods: A cross-sectional study design was used to examine the role of the NON-CHE on CRC
screening intent. Participant’s demographics, current knowledge of CRC screening guidelines, screening
behaviors, and screening intent were collected. Data were analyzed using descriptive and comparison
analyses. A multivariate linear regression was fit to participant’s survey scores with age, race, gender, and
education as covariates. All analyses were done in R 3.5.2.
Results: The NON-CHE engaged 441 underserved residents in Virginia. Overall mean age was 46 years;
mean age from 40+ was 67 years; and mean age for CRC screening age-eligible participants was 52
years (male: 57; female: 56). White participants had significantly higher test scores, correctly answering
1.94 (p=0.007) more questions on average, controlling for the effect of other included demographic
variables. Participants who had some college or were college graduates had significantly higher test
scores, correctly answering 1.65 (p=0.008) and 1.79 (p<0.001) more questions on average, respectively,
controlling for the effect of other included demographic variables. Greater than 95% of participants agreed
that S2S sessions impacted their intent to get screened for CRC.
Conclusions: Equity of access to the health care system can be achieved with precision population health
strategies (PPHS). The NON-CHE as a PPHS allows underserved populations entry into the health care
system at earlier stages, considering intent to screen as a proxy for the health care system. The NON-
CHE combined with S2S was used as a tool to engage minority and rural communities about the
importance of CRC screening and found to impact participant’s intent to “Get Screened”. Such programs
can assist in achieving the national initiative of screening 80% in Every Community.
Keywords: Equity of access, community health educator, precision population health