Developmental milestones across the programmatic life cycle

Implementing the CDC's Colorectal Cancer Screening Demonstration Program

Authors

  • Rebecca Glover-Kudon PhD, MSPH,

    Corresponding author
    1. University Health Center, University of Georgia, Athens, Georgia
    2. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
    • Corresponding author: Rebecca Glover-Kudon, PhD, MSPH, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Program Services Branch, 4770 Buford Highway, NE, Bldg. 107, MS F-76, Atlanta, GA 30341; Fax: (770) 488-3230; RGloverKudon@cdc.gov

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  • Amy DeGroff PhD, MPH,

    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Elizabeth A. Rohan PhD, MSW,

    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • Judith Preissle EdD,

    1. Qualitative Research Program, University of Georgia, Athens, Georgia
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  • Jennifer E. Boehm MPH

    1. Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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  • The articles in this supplement were commissioned based on participation in evaluating the Centers for Disease Control and Prevention–funded Colorectal Cancer Screening Demonstration Program.

  • The opinions or views expressed in this supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the journal editors, the American Cancer Society, John Wiley & Sons, Inc., or the Centers for Disease Control and Prevention.

  • The authors are grateful to Djenaba Joseph and Thomas J. Chapel for their thoughtful reviews of this manuscript.

Abstract

BACKGROUND

In 2005 through 2009, the Centers for Disease Control and Prevention (CDC) funded 5 sites to implement a colorectal cancer screening program for uninsured, low-income populations. These 5 sites composed a demonstration project intended to explore the feasibility of establishing a national colorectal cancer screening program through various service delivery models.

METHODS

A longitudinal, multiple case study was conducted to understand and document program implementation processes. Using metaphor as a qualitative analytic technique, evaluators identified stages of maturation across the programmatic life cycle.

RESULTS

Analysis rendered a working theory of program development during screening implementation. In early stages, program staff built relationships with CDC and local partners around screening readiness, faced real-world challenges putting program policies into practice, revised initial program designs, and developed new professional skills. Midterm implementation was defined by establishing program cohesiveness and expanding programmatic reach. In later stages of implementation, staff focused on sustainability and formal program closeout, which prompted reflection about personal and programmatic accomplishments.

CONCLUSIONS

Demonstration sites evolved through common developmental stages during screening implementation. Findings elucidate ways to target technical assistance to more efficiently move programs along their maturation trajectory. In practical terms, the time and cost associated with guiding a program to maturity may be potentially shortened to maximize return on investment for both organizations and clients receiving service benefits. Cancer 2013;119(15 suppl):2926–39. © 2013 American Cancer Society.

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