TRANSFORMING RESEARCH FINDINGS INTO ACTION: BUILDING A COMMUNICATIONS STRATEGY TO PROMOTE CHANGE AT THE LOCAL, REGIONAL, & STATE LEVEL

Transcription

1 TRANSFORMING RESEARCH FINDINGS INTO ACTION: BUILDING A COMMUNICATIONS STRATEGY TO PROMOTE CHANGE AT THE LOCAL, REGIONAL, & STATE LEVEL BEV GREEN, KAISER PERMANENTE WASHINGTON LAUREN ADAMS, DIRECTOR OF COMMUNICATIONS & PUBLIC RELATIONS, ACADEMYHEALTH AMANDA PETRIK, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH LAURA-MAE BALDWIN, UNIVERSITY OF WASHINGTON GLORIA CORONADO, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH This presentation was supported by Cooperative Agreement Number, DP005013, under the Health Promotion and Disease Prevention Research Centers Program, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.

2 OUR PANEL S STORY BeneFIT:A hybrid implementation-effectiveness study Strategic Communications: An overview from AcademyHealth How BeneFIT used learnings from AcademyHealth BeneFIT Washington: Focus on policy change BeneFIT Oregon: Focus on communication Discussion

3 A PILOT PROGRAM OF MAILED FECAL IMMUNOCHEMICAL TESTING (FIT) TO INCREASE COLORECTAL CANCER SCREENING RATES BENEFIT

4 WHAT IS BENEFIT? A colorectal cancer screening program: administered by Medicaid/Medicare health insurance plans, that mails FIT colorectal cancer screening tests to eligible enrollees, aiming to increase colorectal cancer screening

5 BENEFIT PROCESS Research team provided expertise to the quality teams at the health plans Quality teams designed their own programs to fit their contexts The health plans developed two very different models

6 HEALTH PLAN MAILED FIT PROGRAM MODELS Collaborative Model Centralized Model Worked with clinics to confirm the list of eligible enrollees, co-brand mailing materials, and choose FIT test type that was specific to the clinic. Clinics or providers could opt out if desired. Worked with an outside vendor for mailings. Worked with an outside vendor for most mailed FIT activities.

7 BENEFIT STUDY METHODS Hybrid implementation-effectiveness study of two mailed FIT program models developed by health insurance plans. Primary effectiveness outcome: FIT completion rate within 6 months of initial mailing.

8 BENEFIT RESULTS BY HEALTH PLAN 25% 20% 15% 17.4% 19.6% 18.2% 21.6% 10% 5% 0% Health Plan A (N=2,812) FIT Return Rate Any CRC Screening Rate Health Plan B (N=8,551)

9 CONCLUSIONS Health plans can tailor mailed FIT programs to their resources and culture a centralized model and a model collaborating with health care systems. Both program models were effective and reached many individuals who were overdue for CRC screening. Next steps: Dissemination

10 BENEFIT DISSEMINATION Three pronged approach Traditional academic publications 13 papers published, in process, or planned Presentations at national conferences 10 presentations given or planned Transforming our research findings into on-the-ground action

11 BUILDING A COMMUNICATIONS STRATEGY TO MOVE RESEARCH FINDINGS INTO ACTION

12 STRATEGIC COMMUNICATION IS KEY TO MOVING EVIDENCE TO ACTION Research Producer Research User

13 ELEMENTS OF A COMMUNICATION PLAN Goal Audience Message Channel Collateral

14 DEFINE THE GOAL Four main types of communications goals Awareness Engagement Advocacy Action Can be viewed as a continuum Awareness Engagement Advocacy Action

15 DEFINE THE AUDIENCE Your target audience has the power to help achieve your goal Defined by characteristics such as geography or realms of influence Important to distinguish between your target audience and their influencers

16 UNDERSTAND THE AUDIENCE What do they worry about? What do they want? Who influences them? Who do they trust? Where do they get their info? What have they done recently? What do they believe?

17 DEVELOP YOUR MESSAGE Invert the Abstract Lead with conclusions and impact Describe how you got there Then, and only if interested, share the methods.

18 Message Madlibs FOCUS YOUR PITCH I m here today to talk to you about It s important because My research shows Let me give you can example That s why I m asking you to

19 TRANSFORMING RESEARCH FINDINGS INTO ACTION BUILDING A COMMUNICATIONS STRATEGY TO PROMOTE CHANGE AT THE LOCAL, REGIONAL, AND STATE LEVEL

20 TRANSFORMING OUR RESEARCH FINDINGS INTO ACTION: DISSEMINATING TO OTHER HEALTH PLANS Attended an AcademyHealth Communications Workshop in June 2018 Learned new strategies for communicating and disseminating research findings Oregon and Washington teams brainstormed goals for real world dissemination Research team met, discussed, and revised dissemination project ideas in October 2018 Now working on our action plans

21 BENEFIT WORKSHOP Date: Wednesday, October 10 th Time: 12:00-4:00 PM PST Participants: University of Washington/Kaiser Washington, Kaiser Northwest, Care Oregon Time Topic Lead 12:00 Lunch (30 min) Malaika 12:30 Goals for meeting (10 min) Laura-Mae 12:40 Review Academy Health slides (10 min) (slides 1-5) Laura-Mae 12:50 Brief presentations of ideas from WA & OR (25 min) Malaika/Gloria 1:15 Discussion of ideas for OR (60 min) Amanda 2:15 Discussion of ideas for WA (45 min) Laura-Mae 3:00 Next steps and timeline (30 min) Laura-Mae

22 BENEFIT WORKSHOP Set Goals Identify Audience Develop Messages and Communication Channels

23 COMMUNICATIONS WORKSHEET What are your goals? What are you trying to accomplish? Awareness (e.g., wanting people to know about BeneFIT) Engagement (e.g., wanting to increase audience members talking about BeneFIT and the barriers and facilitators to implementing) Advocacy (e.g., wanting some kind of policy change, public or private, to endorse the use of mailed FIT) Action (e.g, wanting to see the audience using a mailed FIT program) Who is your audience?

24 COMMUNICATIONS WORKSHEET Audience Profile What are their goals? (e.g., earn incentives, increase screening rates, make a profit) Where do they get their information? (e.g., conferences, workshops, funding agencies, internet, personal recommendations) What is the best way to reach out to them? (e.g., , in-person, mutual introduction, phone call) What resources do you need to accomplish this goal? (e.g., website cost and maintenance, Twitter account, personal connections, printer, travel and meeting time, poster) Messaging Mad Libs (meetings, elevator pitch, interviews, media) I m here today to talk to you about...it s important because My research shows Let me give you an example That s why I m asking you to One Liner (Social Media, Blog Post )

25 BENEFIT WORKSHOP PLAN A

26 TRANSFORMING RESEARCH FINDINGS INTO ACTION WORKING ACROSS WASHINGTON S MEDICAID HEALTH PLANS

27 EXAMINED KEY LEARNINGS FROM BENEFIT If mailed FIT programs were implemented state-wide, Washington Medicaid CRC screening rates could increase from 46% to roughly 56%. Washington s health plan dropped the Medicaid population from its Y2 mailed FIT program Other Oregon health plans were interested in adopting a mailed FIT approach No CRC screening incentives for Medicaid in WA state. Only incentives for CRC screening are for Medicare through the Five-Star Quality Rating System. OR has incentives for CRC screening for both Medicaid and Medicare recipients.

28 IDENTIFIED OUR GOAL Chose an advocacy goal To incentivize CRC screening for Medicaid patients in Washington state

29 WORKED TO UNDERSTAND OUR AUDIENCE Identified our Audience: Washington s Health Care Authority (Medicaid Program) What and who influences the Health Care Authority? What do they care about? Met with key informant -- prior medical director of the Medicaid program and asked: Who makes decisions about Medicaid health plan programs? How should we best approach this goal? What would be the best message to advocate for this goal?

30 KEY LEARNING ABOUT OUR AUDIENCE From formal Medicaid Director: There are many ways to influence health plans: Medicaid program mandates Public accountability published comparative CRC screening rates Strong required metrics Incentives can be challenging to implement

31 GOAL SHIFT Shifted our goal To increase uptake of mailed FIT by Medicaid health plans across Washington

32 CONTINUED TO MEET WITH KEY INFORMANTS BeneFIT Advisory Group of representatives from WA and OR Departments of Health, American Cancer Society, and the health plans WA Department of Health representative interested in collaborating with our team Arranged for BeneFIT team to present at a meeting of the Health Care Authority (Medicaid program) and its contracted Medicaid health plans

33 WASHINGTON STATE CRC SCREENING RATES HAVE NOT REACHED THE HEALTHY PEOPLE 2020 OR THE NATIONAL COLORECTAL CANCER ROUNDTABLE 80 BY 2018 GOALS 80% NCCRT 2018 Target (80.0%) 70% Healthy People 2020 Target (70.5%) 60% 50% 40% 59.9% 47.0% 61.5% 53.5% Washington State Average (58.8%) 39.8% 55.9% Washington State Medicaid Average (45.6%) 30% 20% 10% 0% Urban Counties (N=21) Rural Counties (N=18) Overall Rates Medicaid Rates Commercial Rates Sources: Washington Health Alliance (WHA), 2018 National Colorectal Cancer Roundtable (NCCRT) Office of Disease Prevention and Health Promotion (ODPHP)

34 25% BENEFIT RESULTS FOR MEDICAID- ONLY ENROLLEES BY HEALTH PLAN 20% 15% 17.4% 19.6% 18.8% 22.5% 10% 5% 0% Health Plan A (N=2,325) FIT Return Rate Any CRC Screening Rate Health Plan B (N=6,752)

35 POSITIVE RESPONSE FROM HEALTH CARE AUTHORITY & THE HEALTH PLANS Regular strategic meetings with an assigned HCA liaison Identifying HCA methods for moving mailed FIT programs forward requiring new Medicaid metrics including mailed FIT in the Medicaid contracts

36 POTENTIAL COST IMPLICATIONS OF A MAILED FIT PROGRAM FOR WASHINGTON S MEDICAID POPULATION 10,000 Medicaid enrollees 18.8% return rate ~8% positive results ~5% with cancer ~35% with advanced adenomas 1,880 FIT returns 150 positive FITs $1K/pt for follow-up colonoscopies of positive FITs 8 cancers detected 52 with advanced adenomas 5 will develop cancer $50-194K/pt savings in the first year of treatment if cancer prevented $ K/pt savings in the first year of treatment if detected early rather than late stage

37 WASHINGTON ONGOING ACTION PLAN

38 TRANSFORMING RESEARCH FINDINGS INTO ACTION DISSEMINATING MAILED FIT ACROSS OREGON

39 BENEFIT DISSEMINATION PROJECT: Goals: OREGON To raise awareness of the success of the BeneFIT program; To encourage the adoption of mailed FIT outreach programs among health plans, using the model that matched their resources and preferences.

40 WHAT HAVE WE DONE: HEALTH SYSTEM SPREAD 14 Spread of BeneFIT at CareOregon Research systems Non-research systems

41 HEALTH PLAN OREGON: ORIGINAL CLINICS

42 SPREAD TO ADDITIONAL HEALTH PLANS

43 TECHNICAL ASSISTANCE MODELS Webinar 1 - Stories of Success: Examples of Effective Partnerships and Practices to Improve Colorectal Cancer Screening Rates This webinar will include an overview of Oregon s policy and performance landscape, current research, and case studies from clinics and CCOs that have improved colorectal cancer screening rates. Technical Assistance: One-on-One Opportunities We can provide TA on visit-based workflows, direct mail programs, screening strategies, screenings modalities, and other topics. Consultations last one hour and are provided by phone. Date: Open enrollment any time between March 1-May 20 Eligibility: Participation in any one of the above Registration: Please use this link to APPLY (note: space is limited)

44 AUDIENCE Health Plans and Coordinated Care Organizations Clinic and Community Leaders

45 COMMUNICATION CHANNELS Technical Assistance Webinars National Colorectal Cancer Roundtable (e.g. Resource Guides) Social Media LinkedIN, Twitter Meetings/ Presentations Clinic Leaders Oregon Health Authority CCO Technical Assistance Workshop Conferences (Dissemination & Implementation, HCSRN, CCO conference)

46 CRAFTING OUR MESSAGE I'm here today to talk to you about an easy way to save lives and save money. It's important because CRC is the 2nd leading cause of cancer death and is highly preventable. My research shows this program increased screening. Let me give you an example, recently, Care Oregon clinics were able to increase their screening rates by as much as 24%. That's why I'm asking you to consider adopting a centralized (health plan driven) program to mail fecal tests.

47 COMMUNICATION COLLATERAL: SOCIAL MEDIA

48 COMMUNICATION COLLATERAL Implementation how-to

49 NEXT STEPS Continue to deliver technical assistance Launch social media campaign Share success stories with partners

50 DISCUSSION

51 CONTACT US Lauren Adams, AcademyHealth Gloria Coronado, KPCHR Laura-Mae Baldwin, UW Beverly Green, KPWHRI Amanda Petrik, KPCHR