{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T15:46:51Z","timestamp":1781884011863,"version":"3.54.5"},"reference-count":11,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["Contract No. 200-2014-61263 Task 4"],"award-info":[{"award-number":["Contract No. 200-2014-61263 Task 4"]}],"id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Promotion Practice"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>The objective of this study was to analyze the effectiveness and cost of patient incentives, together with patient navigation and patient reminders, to increase fecal immunochemical test (FIT) kit return rates and colorectal cancer screening uptake in one federally qualified health center (FQHC) in Appalachia. This FQHC is a designated homeless clinic, as 79.7% of its patient population are homeless. We collected process, outcome, and cost data from the FQHC for two time periods: usual care (September 2016\u2013August 2017) and implementation (September 2017\u2013September 2018). We reported the FIT kit return rate, the increase in return rate, and the additional number of individual screens. We also calculated the incremental cost per additional screen. The patient incentive program, with patient navigation and patient reminders, increased the number of FIT kits returned from the usual care period to the implementation period. The return rate increased by 25.9 percentage points (from 21.7% to 47.6%) with an additional 91 people screened at an incremental cost of $134.61 per screen. A patient incentive program, together with the assistance of patient navigators and supplemented with patient reminders, can help improve CRC screening uptake among vulnerable and homeless populations.<\/jats:p>","DOI":"10.1177\/1524839920954165","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T06:12:15Z","timestamp":1601359935000},"page":"905-909","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["The Effectiveness and Cost to Improve Colorectal Cancer Screening in a Federally Qualified Homeless Clinic in Eastern Kentucky"],"prefix":"10.1177","volume":"21","author":[{"given":"Vicky","family":"Hardin","sequence":"first","affiliation":[{"name":"Little Flower Clinic, Hazard, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence K. L.","family":"Tangka","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teri","family":"Wood","sequence":"additional","affiliation":[{"name":"Kentucky Department for Public Health, Frankfort, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Boisseau","sequence":"additional","affiliation":[{"name":"Kentucky Department for Public Health, Frankfort, KY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6205-1212","authenticated-orcid":false,"given":"Sonja","family":"Hoover","sequence":"additional","affiliation":[{"name":"RTI International, Waltham, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"DeGroff","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Boehm","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujha","family":"Subramanian","sequence":"additional","affiliation":[{"name":"RTI International, Waltham, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,29]]},"reference":[{"key":"bibr1-1524839920954165","doi-asserted-by":"crossref","unstructured":"Community Preventive Services Task Force. (2012). Updated recommendations for client- and provider-oriented interventions to increase breast, cervical, and colorectal cancer screening. American Journal of Preventive Medicine, 43(1), 92\u201396. https:\/\/doi.org\/10.1016\/j.amepre.2012.04.008","DOI":"10.1016\/j.amepre.2012.04.008"},{"key":"bibr2-1524839920954165","doi-asserted-by":"crossref","unstructured":"Conn M. E., Kennedy-Rea S., Subramanian S., Baus A., Hoover S., Cunningham C., Tangka F. K. L. (2020). Cost and effectiveness of reminders to promote colorectal cancer screening uptake in rural federally qualified health centers in West Virginia. Health Promotion Practice, 21(6), 891\u2013897. https:\/\/doi.org\/10.1177\/1524839920954164","DOI":"10.1177\/1524839920954164"},{"key":"bibr3-1524839920954165","unstructured":"Health Resource and Services Administration. (2018). Glossary. https:\/\/bphc.hrsa.gov\/programrequirements\/compliancemanual\/glossary.html"},{"key":"bibr4-1524839920954165","doi-asserted-by":"crossref","unstructured":"Kim K. E., Tangka F. K. L., Jayaprakash M., Randal F. T., Lam H., Freedman D., Carrier L. A., Sargant C., Maene C., Hoover S., Joseph D., French C., Subramanian S. (2020). Effectiveness and cost of implementing evidence-based interventions to increase colorectal cancer screening among an underserved population in Chicago. Health Promotion Practice, 21(6), 884\u2013890. https:\/\/doi.org\/10.1177\/1524839920954162","DOI":"10.1177\/1524839920954162"},{"key":"bibr5-1524839920954165","doi-asserted-by":"crossref","unstructured":"Knight J. R., Kanotra S., Siameh S., Jones J., Thompson B., Thomas-Cox S. (2015). Understanding barriers to colorectal cancer screening in Kentucky. Preventing Chronic Disease, 12, E95. https:\/\/doi.org\/10.5888\/pcd12.140586","DOI":"10.5888\/pcd12.140586"},{"key":"bibr6-1524839920954165","doi-asserted-by":"crossref","unstructured":"Nadel M. R., Royalty J., Joseph D., Rockwell T., Helsel W., Kammerer W., Gray S. C., Shapir J. A. (2019). Variations in screening quality in a federal colorectal cancer screening program for the uninsured. Preventing Chronic Disease, 16, Article 180452. https:\/\/doi.org\/10.5888\/pcd16.180452","DOI":"10.5888\/pcd16.180452"},{"key":"bibr7-1524839920954165","unstructured":"Pollard K., Jacobsen L. A. (2019, May). The Appalachian Region: A data overview from the 2013-2017 American Community Survey Chartbook. Appalachian Regional Commission & Population Reference Bureau. https:\/\/www.arc.gov\/assets\/research_reports\/DataOverviewfrom2013to2017ACS.pdf"},{"key":"bibr8-1524839920954165","doi-asserted-by":"crossref","unstructured":"Sabatino S. A., Lawrence B., Elder R., Mercer S. L., Wilson K. M., DeVinney B., Melillo S., Carvalho M., Taplin S., Bastani R., Rimer B. K., Vernon S. W., Melvin C. L., Taylor V., Fernandez M., Glanz K. & Community Preventive Services Task Force. (2012). Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: Nine updated systematic reviews for the guide to community preventive services. American Journal of Preventive Medicine, 43(1), 97\u2013118. https:\/\/doi.org\/10.1016\/j.amepre.2012.04.009","DOI":"10.1016\/j.amepre.2012.04.009"},{"key":"bibr9-1524839920954165","doi-asserted-by":"crossref","unstructured":"Siegel R. L., Sahar L., Robbins A., Jemal A. (2015). Where can colorectal cancer screening interventions have the most impact? Cancer Epidemiology, Biomarkers & Prevention, 24(8), 1151\u20131156. https:\/\/doi.org\/10.1158\/1055-9965.EPI-15-0082","DOI":"10.1158\/1055-9965.EPI-15-0082"},{"key":"bibr10-1524839920954165","doi-asserted-by":"crossref","unstructured":"Tangka F. K. L., Subramanian S., Hoover S., DeGroff A., Joseph D., Wong F. L., Richardson L. C. (2020). Economic evaluation of interventions to increase colorectal cancer screening at federally qualified health centers. Health Promotion Practice, 21(6), 877\u2013883. https:\/\/doi.org\/10.1177\/1524839920954168","DOI":"10.1177\/1524839920954168"},{"key":"bibr11-1524839920954165","doi-asserted-by":"crossref","unstructured":"Wadhera R. K., Choi E., Shen C., Yeh R. W., Joynt Maddox K. E. (2019). Trends, causes, and outcomes of hospitalizations for homeless individuals: A retrospective cohort study. 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