Alumna's Study Identifies Organizational Structure as Key to Improving Colorectal Cancer Screening in Federally Qualified Health Centers

Alumna Emanuelle Dias, PhD, publishes a new study that focuses on the impact of organizational readiness on colorectal cancer (CRC) screening in federally qualified health centers. Recently published in the Journal of Clinical and Translational Science, this work builds on research from her dissertation. 

Evidence-based interventions (EBIs) exist to increase colorectal cancer (CRC) screening, but implementation remains slow in federally qualified health centers (FQHCs). 

‘23 graduate and first author Dias and her team examined key factors influencing health centers' readiness and implementation of CRC screening. The team reviewed survey data collected from 57 health centers which reported metrics on components like frequency of provider and patient reminders, provider assessments and feedback. This survey assessed how prepared these health centers are to implement screening interventions.  

The authors identified that a health center's organizational structure and overall workflow were critical in successfully implementing patient reminders for screenings. "Clinics with well-structured workflow systems tend to implement this intervention more consistently," Dias explained. "We also found that clinics that reported inconsistent implementation of patient reminders had lower organizational structure scores than those with planned or fully implemented interventions." 
This finding is critical because EBIs are often inconsistently applied, limiting their reach and effectiveness. According to Dias, health centers may struggle with weak organizational structures due to under-resourced communities with funding challenges, staff turnover, and high patient loads, making implementing EBIs more difficult. 

For Dias, this publication and her research resonate deeply with her background and academic pursuits. "My journey into cancer prevention was deeply personal. When I was in grade school, my mom was diagnosed with breast cancer, which shaped my passion for cancer prevention research," she shared. This experience led Dias to her passion for a line of cancer control and prevention research and a focus on implementing CRC screenings. 

Dias completed her PhD in 2023 at UTHealth Houston School of Public Health with a concentration in Behavioral Sciences. She now works as an Oak Ridge Institute for Science and Education Research Fellow with the US Army.  

Additional authors included School of Public Health faculty Timothy J. Walker, PhD; Bijal A. Balasubramanian, MBBS, PhD; Paula M. Cuccaro, PhD; Maria E. Fernandez, PhD. External authors included University of South Carolina Arnold School of Public Health faculty Lauren Workman, PhD, and Abraham Wandersman, PhD, with the Wandersman Center.