CRC Screening in Unscreened Individuals 45-54

Measurement of acceptability and feasibility of implementation strategies

For our primary outcome, participants will be asked to rate the acceptability and feasibility of implementation strategies using a previously validated instrument, which the investigator previously used with CHC staff. This tool has demonstrated good internal consistency reliability (0.85 for acceptability and 0.89 for feasibility) and similarly good test-retest reliability (correlations: acceptability- 0.80; feasibility - 0.88) and validity in a known groups analysis. There are no cut off numbers for acceptability and feasibility as these are just means but higher scores reflect higher acceptability. However, our surveys will allow us to better understand our survey findings. Quantitative survey interviews will be collected after first and second cycle of testing. The surveys and interviews will be measured together as this is a mixed methods study.

Measurement of reach, effectiveness, and maintenance of implementation strategies

For secondary outcomes, descriptive statistics (relative frequencies, means, variability) will be used to evaluate reach (the number of patients offered CRC screening measured by calculating the number of patients with a FIT order or colonoscopy referral during the pilot testing period), effectiveness (time to CRC screening measured by assessing the difference in the date CRC screening was completed compared to the start date of pilot testing and number screened for CRC pre and post intervention), and maintenance (percentage of program components maintained). The investigator will use generalized linear models to estimate the level of effectiveness, reach, and maintenance across clinical characteristics and sociodemographics with a particular focus on characteristics around equity. This is a mixed methods study where interviews and descriptive statistics will be measured together as mixed methods study.