The unique focus and contribution of the Colorado site to the Cancer Prevention and Control Research Network is to increase the impact of cancer screening and the health of cancer survivors by accelerating the use and dissemination of evidence-based strategies in high-risk individuals. While much has been invested at the provider level toward improving the collection and use of risk assessment information (e.g. personal or family history of cancer, or smoking history), this has yielded little progress, and multi-level approaches that combine provider with patient and system level activities are lacking. Further, there are shelf-ready knowledge translation products for risk-based prevention available that remain under-utilized. The purpose of this research project is to identify gaps in meeting current evidence-based guidelines for risk-appropriate care and to develop and disseminate an implementation strategy to increase their use in communities with a high cancer burden including rural, minority, and the medically under-served.


We will use a community-based participatory approach to engage key stakeholders to identify gaps. We will then co-produce and disseminate with diverse partners multi-level intervention components, such as educational and technical assistance materials. Partners  include: a statewide, grass-roots organization of patient navigators and community health workers whose members represent healthcare systems and community-based organizations reaching the medically under-served; the statewide primary care association which includes 20 clinic systems comprising the backbone of Colorado’s primary care safety net; the Colorado Rural Health Center; the Patient Navigator Training Collaborative; and ECHO Colorado (Extension for Community Health Outreach).

Project Outcomes and Long-term Goal

The impact of these activities and outputs will be evaluated using mixed methods with a type 3 implementation/effectiveness hybrid design to assess change in the degree of implementation (providers and system level) and change in number of patients with risk factors documented by their provider (patient level). The impact of these activities will be amplified and expanded with the patient navigator workforce, innovative e-learning communities, and designated project resources to participate in multi-site research and dissemination activities in the Network. The long-term goal is to develop needed strategies at the patient, provider, and system level in under-served communities with a high cancer burden to realize the benefits of targeting those at high risk for appropriate cancer prevention and control programs and clinical preventive services.