UH3 Project: Strategies and Opportunities to Stop Colorectal Cancer in Priority Populations (STOP CRC)

UH3 Project: Strategies and Opportunities to Stop Colorectal Cancer in Priority Populations (STOP CRC)

Principal Investigator: Gloria D. Coronado, PhD

Co-Principal Investigator: Beverly B. Green, MD, MPH

Sponsoring Institution: Kaiser Permanente Center for Health Research


  • Federally qualified health centers in the Oregon Community Health Information Network (OCHIN)

  • Kaiser Permanente Washington Health Research Institute

  • The National Center for Complementary and Integrative Health (NCCIH)

NIH Institute Providing Oversight: National Cancer Institute (NCI)

Program Official: Erica Breslau (NCI)

Project Scientist: Jerry Suls (NCI)

ClinicalTrials.gov Identifier: NCT01742065

Study Locations: Affiliated clinics in California and Oregon 

Trial Status: Completed

Colorectal cancer (CRC) is the second leading cause of cancer death in the United States. Yet CRC is 90% curable with timely detection and appropriate treatment of precancerous polyps; increased screening could reduce incidence by up to 50%. Rates of CRC screening are extremely low in patients at federally qualified health centers (FQHCs), which serve nearly 19 million patients annually. To address this disparity, the STOP CRC trial tests a culturally tailored, health care system–based program to improve CRC screening rates in OCHIN, a community-based collaborative network of more than 200 FQHCs. Results will provide information on how to use electronic health record resources to optimize guideline-based screening in FQHC clinics whose patient populations have disproportionately low CRC screening rates.

NIH Project Information


5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)


4/20/2015: Interview with co-principal investigators Dr. Gloria Coronado and Dr. Beverly Green (PDF)

Supplementary Material

Regulatory and Ethics Support Documentation


Readiness Assessment Questionnaires


STOP CRC Clinic Materials


Challenges in assessing population reach in a pragmatic trial. Prev Med Rep. 2019 May 29;15:100910.

Factors affecting adherence in a pragmatic trial of annual fecal immunochemical testing for colorectal cancer. J Gen Intern Med. 2019;34(6):978-985.

Using a continuum of hybrid effectiveness-implementation studies to put research-tested colorectal screening interventions into practice. Implement Sci. 2019;14(1):53.

A cost-effectiveness analysis of a colorectal cancer screening program in safety net clinics. Prev Med. 2019;120:119-125.

Effectiveness of automated and live phone reminders after mailed-FIT outreach in a pilot randomized trial. Prev Med Rep. 2018;12:210-213.

Two Medicaid health plans' models and motivations for improving colorectal cancer screening rates. Transl Behav Med. 2018 Nov 16. doi: 10.1093/tbm/iby094. [Epub ahead of print]

Positive predictive values of fecal immunochemical tests used in the STOP CRC pragmatic trial. Cancer Med. 2018;7(9):4781-4790.

Effectiveness of a mailed colorectal cancer screening outreach program in community health clinics: the STOP CRC cluster randomized clinical trial. JAMA Intern Med. 2018;178(9):1174-1181.

Predictors of colorectal cancer screening prior to implementation of a large pragmatic trial in Federally Qualified Health Centers. J Community Health. 2018;43(1):128-136.

Effect of reminding patients to complete fecal immunochemical testing: a comparative effectiveness study of automated and live approaches. J Gen Intern Med. 2018;33(1):72-78.

Implementation successes and challenges in participating in a pragmatic study to improve colon cancer screening: perspectives of health center leaders. Transl Behav Med. 2017;7(3):557-566.

Applying the Plan-Do-Study-Act (PDSA) approach to a large pragmatic study involving safety net clinics. BMC Health Serv Res. 2017;17(1):411.

Mapping multi-site clinic workflows to design systems-enabled interventions. EGEMS (Wash DC). 2017;5(1):13.

The validation of electronic health records in accurately identifying patients eligible for colorectal cancer screening in safety net clinics. Fam Pract. 2016;33(6):639-643.

Timeliness of follow-up to a positive fecal immunochemical test result among community health center patients. J Patient Cent Res Rev. 2016;3(3):179.

Timeliness of colonoscopy after abnormal fecal test results in a safety net practice. J Community Health. 2016;41(4):864-70.

Recruiting community health centers into pragmatic research: findings from STOP CRC. Clin Trials. 2016;13(2):214-222.

Analytic challenges arising from the STOP CRC trial: pragmatic solutions for pragmatic problems. EGEMS (Wash DC). 2015;3(1):1200.

Reasons for non-response to a direct-mailed FIT kit program: lessons learned from a pragmatic colorectal-cancer screening study in a federally sponsored health center. Transl Behav Med. 2015;5(1):60-67.

Clinical perspectives on colorectal cancer screening at Latino-serving federally qualified health centers. Health Educ Behav. 2015;42(1):26-31.

Health policy to promote colorectal cancer screening: improving access and aligning federal and state incentives. Clin Res (Alex). 2015;29(1):50-55.

"BeneFITs" to increase colorectal cancer screening in priority populations. JAMA Intern Med. 2014;174(8):1242-1243.

Strategies and Opportunities to STOP Colon Cancer in Priority Populations: design of a cluster-randomized pragmatic trial. Contemp Clin Trials. 2014;38(2):344-349.

Navigating the murky waters of colorectal cancer screening and health reform. Am J Public Health. 2014;104(6):982-986.

Strategies and opportunities to STOP colon cancer in priority populations: pragmatic pilot study design and outcomes. BMC Cancer. 2014;14:55.

Using an automated data-driven, EHR-embedded program for mailing FIT kits: lessons from the STOP CRC pilot study. J Gen Pract (Los Angel). 2014 Jan 5;2. pii: 1000141.

Advantages of wordless instructions on how to complete a fecal immunochemical test: lessons from patient advisory council members of a Federally Qualified Health Center. J Cancer Educ. 2014;29(1):86-90.


5/1/2019: Presentation to NIH Collaboratory Steering Committee (slides)

5/14/2018: Presentation to NIH Collaboratory Steering Committee (slides)

2/23/2018: PCT Grand Rounds: "Direct Mail Programs Work...But Will Health Centers Implement Them? Findings from STOP CRC" (video; slides)

5/23/2017: Presentation on Top Barriers/Challenges and Recent Generalizable Lessons Learned to NIH Collaboratory Steering Committee (slides)

11/4/16: PCT Grand Rounds: "Colorectal Cancer Screening in Primary Care: A Focus on STOP CRC" (video; slides)

5/9/2016: Presentation on Data Governance and Data Sharing to NIH Collaboratory Steering Committee (slides)

5/9/2016: Presentation on Generalizable Lessons Learned to NIH Collaboratory Steering Committee (slides)

4/24/2015: PCT Grand Rounds: "Analytic Challenges From the STOP CRC Trial: Pragmatic Solutions for Pragmatic Problems" (video; slides)

4/21/2015: Presentation to NIH Collaboratory Steering Committee (slides)

11/7/2014: PCT Grand Rounds: "Early Findings from Strategies and Opportunities to STOP Colon Cancer in Priority Populations" (video; slides)

9/26/2014: PCT Grand Rounds: "Clinical Decision Support to Improve Colorectal Cancer Screening" (video; slides)

4/26/2014: PCT Grand Rounds: "STOP CRC in the Context of an Ethical Framework for Learning Health Systems" (video; slides)

2/24/2014: Presentation to NIH Collaboratory Steering Committee (slides)


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Demonstration Projects: UH3 Project: Strategies and Opportunities to Stop Colorectal Cancer in Priority Populations (STOP CRC). In: Rethinking Clinical Trials: A Living Textbook of Pragmatic Clinical Trials. Bethesda, MD: NIH Health Care Systems Research Collaboratory. Available at: https://rethinkingclinicaltrials.org/demonstration-projects/uh3-project-strategies-and-opportunities-to-stop-colorectal-cancer-in-priority-populations-stop-crc/. Updated January 13, 2020.