{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T19:46:55Z","timestamp":1777664815896,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,7,8]],"date-time":"2015-07-08T00:00:00Z","timestamp":1436313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Educ Behav"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:p>This article presents the results of a process evaluation of the Alaska Native (AN) Colorectal Cancer (CRC) Family Outreach Program, which encourages CRC screening among AN first-degree relatives (i.e., parents, siblings, adult children; hereafter referred to as relatives) of CRC patients. Among AN people incidence and death rates from CRC are the highest of any ethnic\/racial group in the United States. Relatives of CRC patients are at increased risk; however, CRC can be prevented and detected early through screening. The evaluation included key informant interviews (August to November 2012) with AN and non-AN stakeholders and program document review. Five key process evaluation components were identified: program formation, evolution, outreach responses, strengths, and barriers and challenges. Key themes included an incremental approach that led to a fully formed program and the need for dedicated, culturally competent patient navigation. Challenges included differing relatives\u2019 responses to screening outreach, health system data access and coordination, and the program impact of reliance on grant funding. This program evaluation indicated a need for more research into motivating patient screening behaviors, electronic medical records systems quality improvement projects, improved data-sharing protocols, and program sustainability planning to continue the dedicated efforts to promote screening in this increased risk population.<\/jats:p>","DOI":"10.1177\/1090198115590781","type":"journal-article","created":{"date-parts":[[2015,7,8]],"date-time":"2015-07-08T21:44:35Z","timestamp":1436391875000},"page":"35-42","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["A Process Evaluation of the Alaska Native Colorectal Cancer Family Outreach Program"],"prefix":"10.1177","volume":"43","author":[{"given":"Diana","family":"Redwood","sequence":"first","affiliation":[{"name":"Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Provost","sequence":"additional","affiliation":[{"name":"Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen D. S.","family":"Lopez","sequence":"additional","affiliation":[{"name":"University of Alaska Fairbanks, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Skewes","sequence":"additional","affiliation":[{"name":"Montana State University, Bozeman, MT, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhonda","family":"Johnson","sequence":"additional","affiliation":[{"name":"University of Alaska Anchorage, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Christensen","sequence":"additional","affiliation":[{"name":"Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Sacco","sequence":"additional","affiliation":[{"name":"Alaska Native Epidemiology Center, Alaska Native Tribal Health Consortium, Anchorage, AK, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Haverkamp","sequence":"additional","affiliation":[{"name":"Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Albuquerque, NM, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,7,8]]},"reference":[{"key":"bibr1-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2009.04.009"},{"key":"bibr2-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1136\/gut.37.6.830"},{"key":"bibr3-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.2001.0862"},{"key":"bibr4-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1007\/s13187-011-0295-y"},{"key":"bibr5-1090198115590781","doi-asserted-by":"publisher","DOI":"10.3402\/ijch.v72i0.21301"},{"key":"bibr6-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1177\/1524839913513587"},{"key":"bibr7-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199412223312501"},{"key":"bibr8-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1214\/aoms\/1177705148"},{"key":"bibr9-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1188\/12.ONF.299-306"},{"key":"bibr10-1090198115590781","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"bibr11-1090198115590781","unstructured":"Indian Health Service. 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I., Silvey K., Newell N., Coates R. J., Leman R. (2012). Family history of colorectal cancer: Clinicians\u2019 preventive recommendations and patient behavior. Preventing Chronic Disease, 9, E21. 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