Changing Health Systems Using Evidence-based interventions to increase Colorectal Cancer Screening | CDC RFA DP 25 0012

Frequently Asked Questions (FAQs)

1) What is the name of this CDC funding opportunity?

The cooperative agreement is titled "Changing Health Systems Using Evidence-based Interventions to Increase Colorectal Cancer Screening" (CDC RFA DP 25 0012; CFDA 93.800).

2) Which CDC program is offering this opportunity?

The Centers for Disease Control and Prevention (CDC), through NCCDPHP, is offering this cooperative agreement funding opportunity.

3) What is the main purpose of the program?

The purpose is to raise colorectal cancer (CRC) screening rates among adults ages 45 to 75 by working directly with health systems and primary care clinics where screening prevalence is demonstrably low.

4) Who is the priority population for improved screening?

The program targets adults ages 45 to 75, with a strong emphasis on reaching populations with lower screening rates and addressing real-world barriers that prevent people from starting or completing CRC screening.

5) What types of clinic sites qualify as partner sites?

To qualify as a partner site, a clinic must have CRC screening prevalence below the national, regional, or local average.

6) Does the program focus only on overall clinic screening rates?

No. The program also emphasizes sub-populations within clinics that may need extra navigation and support to start or complete screening.

7) What is the core strategy CDC expects recipients to use?

The core strategy is health-systems change using evidence-based interventions (EBIs), specifically multicomponent interventions recommended in The Community Guide.

8) How many evidence-based interventions (EBIs) must be implemented in partner clinics?

Recipients are expected to help partner health systems and clinics implement at least three EBIs.

9) Do the required EBIs need to be different from each other?

Yes. The interventions should be selected so they affect different parts of the clinical system rather than all focusing on the same lever.

10) What is meant by using a mix of EBIs across the clinical system?

The opportunity expects recipients to combine EBIs that (1) increase demand for screening (for example, patient reminders or small media), (2) improve access (for example, reducing structural barriers, streamlining ways to obtain tests, or supporting alternative screening modalities), and (3) strengthen delivery of screening recommendations in clinical care (for example, provider reminders, provider assessment and feedback, or workflow redesign).

11) Is this opportunity aimed at one-time outreach efforts?

No. The intent is to move beyond one-off outreach and embed sustainable screening practices into routine clinic operations.

12) What kinds of partnerships are recipients expected to build and manage?

Funded recipients are expected to build and manage partnerships with health systems and primary care clinics, and also partner with organizations that can support implementation, improve data collection, and strengthen how clinics use electronic health records (EHRs) to manage screening.

13) Why does the announcement emphasize EHR and data capacity?

The announcement highlights that data and workflow capacity are often key to lasting change, so recipients must work to improve data collection and strengthen how clinics use EHRs to manage and track CRC screening.

14) What is a readiness assessment, and is it required?

A formal readiness assessment is required for each partner clinic. It is used to gauge a clinic's capacity for adopting EBIs and is intended to guide EBI selection and tailor implementation support.

15) What clinic capacities are considered in the readiness assessment?

The readiness assessment considers factors such as leadership engagement, staffing, workflow maturity, data quality, and the clinic's ability to track patients across the screening continuum.

16) How is the readiness assessment used after it is completed?

It is not only a planning exercise. The readiness assessment is meant to determine which EBIs are realistic for each clinic and how implementation support should be tailored to help the clinic improve screening rates.

17) What leadership role is required at each partner clinic?

Each partner clinic must have a CRC screening champion to help drive implementation, align teams, and address operational issues that arise.

18) Can grant funds be used to pay for colorectal cancer screening tests?

Yes, recipients are allowed to use a limited portion of funds to pay for stool-based CRC screening tests in partner clinics.

19) Can funds be used to pay for follow-up colonoscopies after abnormal results?

Yes. Funds may be used to ensure follow-up colonoscopies occur after a positive or abnormal screening test.

20) What does "payor of last resort" mean in this announcement?

"Payor of last resort" means program funds are intended to fill gaps only when no other coverage or payment option is available, to prevent patients from dropping out of the screening process due to cost barriers (especially after an abnormal result).

21) What kinds of data reporting are required?

Recipients must submit high-quality clinic-level data, including baseline and annual CRC screening prevalence, aggregate counts of stool-based tests provided and returned, and aggregate data on follow-up colonoscopies (including those paid for with program funds).

22) Is the focus only on distributing stool-based tests?

No. The program focuses on tracking the entire CRC screening process end-to-end, from identifying eligible patients through test completion and diagnostic follow-up after abnormal findings.

23) What does "closing the loop" mean in this program?

It refers to ensuring clinics can track and support patients across the full screening continuum, including making sure abnormal results are followed by appropriate diagnostic follow-up (such as colonoscopy), rather than stopping at outreach or initial testing.

24) Are recipients expected to improve clinic capacity for data quality and tracking?

Yes. Recipients are expected to build clinic and health system capacity to collect reliable data and use systems (including EHR-supported workflows) to track screening end-to-end.

25) What narrative deliverables are required?

Recipients must submit one success story every six months describing implementation lessons, barriers encountered, and approaches that improved screening uptake or completion.

26) What evaluation deliverables are required?

Recipients must plan and carry out an evaluation of program activities and submit an annual evaluation report.

27) Is this a standard grant or a cooperative agreement?

This is a discretionary cooperative agreement, which means recipients can expect substantial federal involvement compared with a standard grant.

28) Who is eligible to apply?

Eligibility is listed as unrestricted. Eligible applicants include state, county, and local governments; tribal governments and tribal organizations; public housing authorities; K-12 independent school districts; public and private institutions of higher education; nonprofits with or without 501(c)(3) status; and for-profit organizations (including small businesses).

29) When was the opportunity created and when does it close?

The opportunity was created on 2024-12-18 and has an original closing date of 2025-02-20.

30) How many awards does CDC anticipate making?

The announcement anticipates up to 38 awards.

31) What is the maximum (ceiling) award amount listed?

The award ceiling is $900,000.

32) What kinds of organizations are this opportunity best suited for?

The announcement is designed for organizations that can coordinate multiple clinic partnerships, implement several complementary EBIs at once, strengthen EHR-enabled screening workflows, and produce credible data showing sustained increases in CRC screening in settings where rates have historically lagged.

33) What types of barriers is the program meant to address?

The program is meant to address real-world barriers that keep people from starting or completing screening, including barriers that affect follow-up after abnormal results and barriers experienced by sub-populations with lower screening rates.

34) What is the expected approach to improving screening in low-prevalence settings?

The approach is to work directly with health systems and primary care clinics where screening prevalence is low, conduct readiness assessments, implement multiple EBIs that target different parts of the system, strengthen data/EHR workflows, and track performance over time using clinic-level data.