# CRC-HUB-SPOKE: A ColoRectal Cancer screening Hub for Southern California community health centers.

> **NIH NIH UH3** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2022 · $459,851

## Abstract

Colorectal cancer (CRC) screening and appropriate follow-up can reduce incidence and mortality. The US 
Preventive Services Task Force (USPSTF) recommends CRC screening through a variety of invasive and non-invasive 
tests for individuals aged 50 to 75 years. Evidence-based interventions (EBIs) and other strategies 
exist to promote CRC screening, but adoption and implementation of these are limited, especially in CHCs. 
Our hypothesis is that a Hub and Spoke multilevel intervention will be superior to usual care. The hub will be 
Health Quality Partners of Southern California (HQP), a non-profit organization comprised of 16 CHC systems 
(spokes), serving 135 rural and urban clinic sites. We propose a 2-phase study to pilot and optimize (Phase I) 
and rigorously test (Phase II) the Hub and Spoke approach and its impact on CRC screening, follow-up, and 
usual care. UG3 Planning/Exploratory Phase AIM: Pilot test the feasibility, acceptability, and preliminary 
outcomes of a multilevel intervention for CRC screening, follow-up, and referral-to-care using a mixed 
methods approach. The intervention includes HQP hub-based delivery of centralized mailed FIT to patients 
served by individual CHCs-spokes plus complimentary provider and clinic-level interventions at CHCs, and 
coordination of a standardized navigation strategy delivered by CHCs for abnormal FIT follow-up. UH3 
Implementation Phase. We will conduct a 2-arm pragmatic randomized trial to assess impact of a 
regionally-developed multilevel intervention to increase CRC screening, follow-up, and referral-to-care 
among CHC patients. The trial will be guided by the Pragmatic, Robust Implementation and Sustainability 
Model (PRISM), which includes outcomes from the Reach, Effectiveness, Adoption, Implementation, 
Maintenance (RE-AIM) framework and expands them with contextual constructs. Aim 1. Assess effectiveness
of the multilevel intervention based on: 1) improvement in proportion up-to-date with screening 3 years post 
implementation; 2) proportion with abnormal FIT who complete diagnostic colonoscopy within 6 months; and 3) 
proportion with CRC completing first treatment evaluation. Aim 2. Evaluate the implementation, scalability, and 
sustainability of a multilevel implementation strategy. Implementation will be evaluated with a mixed methods 
approach using the RE-AIM outcomes of Reach, Adoption, and Implementation as well as the PRISM 
constructs of Intervention Characteristics and Recipients from perspective of multiple stakeholders (i.e. 
patients, front-line staff, and operational leaders). We will also calculate replication costs. Scalability and 
Sustainability will be evaluated using the RE-AIM outcome of Maintenance and the PRISM constructs of 
Implementation & Sustainability Infrastructure and External Environment. Our study will help accelerate 
progress in CRC prevention in underserved populations by identifying multilevel intervention strategies that are 
scalable to additional...

## Key facts

- **NIH application ID:** 10519243
- **Project number:** 3UH3CA233314-04S1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Sheila Faye Castaneda
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $459,851
- **Award type:** 3
- **Project period:** 2019-09-19 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10519243

## Citation

> US National Institutes of Health, RePORTER application 10519243, CRC-HUB-SPOKE: A ColoRectal Cancer screening Hub for Southern California community health centers. (3UH3CA233314-04S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10519243. Licensed CC0.

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