Date of Conferral

4-7-2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Cheryl Anderson

Abstract

Colorectal cancer (CRC) screening rates are lower in rural areas than in urban settings. Individuals in rural areas have lower screening rates due to geographic isolation, provider shortages, and socioeconomic barriers. The purpose of this integrative review was to identify and synthesize best practices for implementing evidence-based strategies to increase CRC screening rates in rural primary care clinics. A systematic literature search across multiple databases identified 24 relevant articles published between 2019 and 2025. The Johns Hopkins Evidence-Based Practice Model (JHEBPM) rated articles for evidence and quality, while the Theoretical Domains Framework (TDF) guided the analysis. Thematic analysis identified four primary themes: collaborative leadership, patient-centered care, community engagement, and resource allocation. Twelve subthemes emerged, including cost-effectiveness, patient outreach, performance improvement, community funding and health program initiatives, collaborative governance, addressing unmet needs, healthcare service delivery, promoting well-being and preventive health, resource diversification, strategic planning, and accountability. Recommendations include promoting collaborative leadership through diversification and accountability, improving patient care through patient outreach and quality improvement, community engagement through improved services, and creating resource planning and allocation through a decision-making model of care. This study provides actionable strategies to improve CRC screening rates in rural primary care clinics, with the potential to drive positive social change by improving colorectal cancer screening outcomes.

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