Provider- and System-Level Barriers and Facilitators to Colonoscopy and Multi-Target Stool DNA for Colorectal Cancer Screening in Rural/Remote Alaska Native Communities
Bibliographic Data
The Alaska Tribal Health System is working to increase colorectal cancer (CRC) screening among Alaska Native people, who experience the highest CRC rates in the world. This study examined CRC screening provider- and system-level barriers and facilitators from the perspective of healthcare providers serving Alaska Native people in rural/remote communities. A total of 28 provider (physicians, advanced practice, and Community Health Aides/Practitioners) interviews were held from 1 February to 30 November 2021. Colonoscopy provider-level barrier themes included time, competing priorities, and staffing, while system-level barriers included travel costs, weather, and the COVID-19 pandemic. Multi-target stool DNA (mt-sDNA) barrier themes included test viability and unfamiliarity, and previous stool tests experiences. For both tests, limited medical record reminders was a major barrier. Facilitator themes for both tests included community outreach, cultural competency and patient navigation, and clinic/system improvements. In-depth interviews with tribal health providers showed that adding mt-sDNA testing may help address system-level colonoscopy barriers such as waitlists and travel costs, but other barriers remain. Further research is needed into patient barriers and facilitators, as well as the effectiveness of integrating mt-sDNA into a geographically dispersed tribal health system to reduce cancer disparities and build equity in CRC prevention among Alaska Native people
Cancer · Colonoscopy · Colorectal cancer · Facilitator · Family medicine · Health care · Health equity · Outreach · Political science · Public health · Staffing · Colorectal Cancer Screening and Detection · Global Cancer Incidence and Screening · Medicine · Nursing · Psychology · Internal Medicine
Using mixed methods in health research
Psychometric assessment of three newly developed implementation outcome measures
Research electronic data capture (Redcap)—A metadata-driven methodology and workflow process for providing translational research informatics support
Snowball Sampling
The Discovery of Grounded Theory
Intercoder Reliability in Qualitative Research
Using Mixed-Methods Sequential Explanatory Design
How Many Interviews Are Enough
| Unique citing works | 1 |
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| Citations per year | 1 |
| Citation span | 2025 - 2025 (1) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 1 |