Date

12-4-2025

Department

School of Health Sciences

Degree

Doctor of Philosophy in Health Sciences (PhD)

Chair

Orchid George

Keywords

cancer screening, colorectal cancer, federally qualified health centers, fecal immunochemical test, vulnerable populations

Disciplines

Public Health

Abstract

Despite strong evidence supporting the effectiveness of colorectal cancer screening in reducing incidence and mortality rates, screening uptake remains suboptimal. Colorectal cancer screening practices have proven to reduce mortality rates in average-risk men and women. Although considerable research has studied colorectal cancer screening in eligible adults, less attention had been paid to eligible adults receiving primary care services through federally qualified health centers. This quantitative, predictive, correlational research study investigated age, sex, race, and health insurance type as continuous predictor variables affecting colorectal cancer screening completion in patients receiving primary care services at federally qualified health centers in North Carolina. The Exploration, Preparation, Implementation, and Sustainment framework was the theoretical framework that guided the study. This research was conducted using secondary data from the SCORE Intervention Trial. A sample size of 2,0011patients from the SCORE Intervention Trial was analyzed using descriptive statistics and multiple logistic regression analysis. Data was collected using electronic health records and a REDCap database and was analyzed using the IBM Statistical Package for the Social Sciences. The results provided helpful information for federally qualified health centers and researchers that can lead to better utilization of health care services, such as uptake in colorectal cancer screening and timely follow-up to colonoscopy. The researcher recommends that future research be conducted using a mixed-methods approach to understand further what deters federally qualified health center patient populations from completing colorectal cancer screening.

Available for download on Friday, December 04, 2026

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