To gain further insight on knowledge and awareness of colorectal cancer (CRC), screening, benefits, barriers, perceived susceptibility, and self-efficacy, we will implement a community survey to adults eligible for CRC screening (age 45-75). Additionally, due to the change in screening recommendations reducing the age to start screening to 45, we will conduct focus groups targeting individuals between 45 and 49 to elicit more detailed information about CRC screening knowledge, beliefs, and preferences.

This initiative provides programmatic and financial support for the implementation of small-scale pilot programs to screen, educate, navigate, develop workflows, and/or analyze data to improve CRC screening. Ideally, these pilot programs will support the first steps towards developing an application to seek further funding to further expand CRC screening services. 

The CONNECT Team and Steering Committee volunteers reviewed the competitive applications for our first year of the Pilot Program initiative and selected three awardees for the one-year program

2025-2026 Pilot Program Recipients:

Hidalgo County Health and Human Services

The program proposed by Hidalgo County Health and Human Services titled “Step Up for Screening: Hidalgo County’s Colorectal Cancer Early Detection Project” (Amy Gonzalez, PI) will focus on community outreach and education, improving pathways for screening and follow-up, and distribution of fecal immunochemical tests (FITs), throughout this border county in south Texas. The infrastructure, standardized processes, and relationships with gastroenterologists and local stakeholders will lead to long-term sustainability.

Hope Clinic

HOPE Clinic’s program, “Colorectal Screening in Diverse Communities of Southwest and North Houston, Texas” (PI: Andrea Caracostis) will prioritize patient education and reminders for screening, identifying barriers, and providing patient navigation to improve screening completion. The data captured through this pilot will support further applications for grant funding for colorectal cancer screening efforts.

Texas Tech University Health Sciences Center

The program titled “Colorectal cancer Awareness and Resources through Engagement with DIGital Innovation (CARE-DIGI)” (PI: Julie St. John) from Texas Tech University Health Sciences Center will develop and implement digital brochures to improve patient education and awareness related to colorectal cancer and screening. An evaluation will be conducted to assess the impact of these brochures on further action, such as completion of colorectal cancer screening. For sustainability, the video content is expected to be adapted for other platforms, and the video brochures will be integrated into clinic workflows.

With data available through the All Payors Claims database, the Texas Cancer Registry, SEER, and other data sources, we aim to include the total cost of care, including treatment costs, to expand upon cost effectiveness analyses that have been conducted previously. This information can provide further evidence to support CRC screening and prevention initiatives.

The priority tasks for this group include improving access to convenient, safe, affordable, and effective CRC screening and treatment throughout the state; and developing a plan for outreach and training to improve stakeholder and community understanding, comfort, and ability to provide advocacy for CRC screening, treatment, and funding.

By identifying and convening gastroenterologists, surgeons, oncologists, health departments, and other collaborators and champions to expand our stakeholder network, we can identify areas of interest, opportunities for engagement, and potential roles in a statewide CRC screening program. Evidence-based practices and implementation guides will be collated, reviewed, and adopted into appropriate settings.

Using best practices, evidence-based strategies, and partners identified through clinical network development, draft a plan to scale current CRC screening efforts into clinical and community settings across the state.

To improve communication and engagement with the stakeholder network and community, it is important to also seek input from that network. We will continue to expand our social media content library and use this website as a resource for the network and wider community. Additionally, the repository of resources, including evidence-based practices on navigation, education, community engagement, and CRC screening will continue to be expanded as more resources are identified.

To assess impact and support planning, implementation, policy development, and advocacy, we will use evaluation methods, innovative modeling, geospatial analysis, and cost effectiveness analyses. The outcomes of these processes include various maps of the state of Texas describing screening rates, locations of Federally Qualified Health Centers, and patients not up to date for screening. The modeling and costing include key elements of a proposed large-scale (state-wide) colorectal cancer screening program. This evaluation will be translated into a user-adjustable dashboard to allow for different scenarios and model parameters to be varied to compare costs and benefits.