Our project is intended to improve the screening rates for colorectal cancer in the Texas panhandle area. The name of the project is: Get FIT to Stay Fit. Stepping up to fight Colorectal Cancer in the Panhandle. The Texas panhandle has unique demographics due to higher uninsured population and large number of refugees from other countries in the area. 22 counties out of the 26 are designated as medically underserved areas. Amarillo population is growing and one of the greatest increases is in the Hispanic community which had a 44% growth over the last decade. In the panhandle area, 33% of population is uninsured, 24% are under poverty level.

In many cases, residents with limited acce...

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Our project is intended to improve the screening rates for colorectal cancer in the Texas panhandle area. The name of the project is: Get FIT to Stay Fit: Stepping up to fight Colorectal Cancer in the Panhandle. The Texas panhandle has unique demographics due to higher uninsured population and large number of refugees from other countries in the area. 22 counties out of the 26 are designated as medically underserved areas. Amarillo population is growing and one of the greatest increases is in the Hispanic community which had a 44% growth over the last decade. In the panhandle area, 33% of population is uninsured, 24% are under poverty level.

In many cases, residents with limited access to care are concentrated at lower educational attainment and income levels. More than one in five Amarillo area residents (21%) reported that they did not see a doctor due to prohibitive costs in 2010, compared to 15% and 19% across the nation and state, respectively. In 2010, 65.4% of US adults were screened for colorectal cancer according to recommended guidelines compared to 59% in Texas and only 41%, Texas Tech University Health Sciences Center (TTUHSC) Amarillo, 2012-13 baseline screening rate of whereas according to Texas cancer registry the overall incidence of colon cancer (CRC) is higher in the panhandle area. Major factors include large uninsured population who are not screened leading to inadequate prevention of precancerous lesions into invasive cancer.

Based on the literature review, needs assessment, and barriers identified in the current system of care delivery, we propose to address two critical barriers to screening; 1) lack of knowledge and awareness of CRC and CRC screening, and 2) lack of access to screening and diagnostic services.

The project is geared towards improving the screening rates for colon cancer in the Texas panhandle. Our program is a multi-component evidence-based program that will target low income, under-educated, and minorities including refugees. This will be achieved by educating the community via community health workers (CHWs), using translation services, distributing stool collection kits, and having them mailed back to the patient navigator.

The FIT kits will be sent to lab for testing and positive tests will be further managed by the referral system in place. The results will be evaluated every 3 months by the data entry done by database manager and statistician and discussed with the patient navigator, PD and Co-PI. Other interventions include reducing structural barriers, using tailored small media, and including client reminders. 

Specific goals include: 1. Increase community awareness and knowledge about CRC and CRC screening; 2. Increase CRC screening rates in underinsured and uninsured population; 3. Increase uptake of diagnosis and treatment services for CRC to reduce the numbers of advanced cases; 4. Increase provider recommendation for CRC screening; and 5. Build a sustainable screening, diagnosis and treatment network for CRC.

Innovative aspects of the program include integrating the outreach, education, no-cost screening, diagnostic and navigation services that target the uninsured while recruiting participants from where they live, seek health care and socialize. Additional strengths are the strategies for sustainability, and the breadth and depth of our community partnerships. This program will address the need of CRC screening in the Texas Panhandle which will include Whites, Hispanics and Blacks (both have higher incidence of CRC than Whites) and refugees especially from Burma, Africa and Middle East. The uniqueness of the program will be in the use of education material which will include multilingual pamphlets, multilingual translation services used by CHWs to educate and increase awareness among in the community.

The program will improve CRC screening rates, increase awareness among the population and reduce the incidence of invasive CRC in the area due to improved screening processes using a multi-component intervention approach.

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