YULE CAPSTONE 2

Improving Colorectal Cancer Screening Rates Through Nurse-Led Education in Primary Care Settings

Student name: Yulexis Moreda

Course: MSN Capstone Project-DBX-DL01

Instructor: Carmen Lazo

Institution: Florida National University

Date: March 18, 2026

Improving Colorectal Cancer Screening Rates Through Nurse-Led Education in Primary Care Settings

Colorectal cancer remains a tremendous pandemic among the health of the American population since it is the second-largest cause of cancer-related death, even though it is preventable through early screening. The current rates of screening among the population remain lower than the suggested ones, particularly concerning the underserved and vulnerable populations with a prevention barrier. There is also poor screening, which results in late diagnosis and more mortalities and considerably increased costs of treatment as a result of late infections of the disease. The financial expense is not only immense on the national and local level, but also in the millions of dollars expended annually, and even additional taxation on the local healthcare infrastructure in areas such as Miami-Dade County. The outcome is also worsened by inequality in access to care among minority and low-income groups. This project will involve an appraisal of a nurse-led intervention tool in education that is capable of resolving the problem of improving the levels of colorectal cancer screening among adults in the range of forty-five to seventy-five years.

PICOT Question and Description

The PICOT framework provides a methodological approach that administers the evidence-based clinical research process and develops measurable healthcare interventions within nursing. It allows the workers of a specific health facility to articulate a clinical problem and outline all methods that can be adopted to improve patient outcomes within a given facility. The PICOT question of the project has been framed in the following format: Does a nurse-led intervention in the primary care clinics of Miami-Dade County, for adults aged between forty-five and seventy-five years, enhance screening completion rates? The question introduces the targeted approach to education to traditional care that is not coupled with uninterrupted patient-centered education (Hashemi et al., 2022). This organization will make it possible to retain the proposed intervention in focus, practical, and aligned with the quantifiable healthcare outcomes.

The intended population of this project will include adults aged forty-five to seventy-five years who are under primary care at clinics located in Miami-Dade County, with a majority of them constituting the different underserved groups. The intervention is based on an education program, with a nurse acting as a leader and involving an interaction with patients one-on-one, offering a personalized counseling session, providing information to patients in an easy-to-understand format, and patient follow-up to remind them of screening. The referrals used by general doctors are the reference. It is expected that the desired change will strive to improve the screening rates of the target population with colorectal screening (Han et al., 2025). The time frame for determining the effectiveness of the intervention is six months following the implementation, whereby sufficient time will be left to assess a change in behavior and screening compliance.

Vulnerable Population and Setting

The vulnerable groups in this project will be the adults between forty-five and seventy-five years who receive care services at the primary care clinics in Miami-Dade County. This group includes the uninsured or underinsured patients, the ethnic minorities, Hispanics, and African Americans, as well as the low-income earners. There is also a high number of patients in the population who lack access to regular healthcare services and have poor health literacy, which is likely to lead to avoidance of preventive screening. The language barriers and cultural beliefs also influence attitudes to screening colorectal cancer and reluctance towards screening (Oladunjoye & Valdez, 2025). Another challenge that influences access to timely preventive medical services is the transportation problems and cost issues.

Several risk factors could be attributed to making this population more vulnerable and increasing their risk of developing colorectal cancer, and rendering this process ineffective. Among older adults above the age of forty-five, the age factor happens to be one of the most significant risk factors, and the family history and lifestyle also contribute towards the rise in the occurrence of type 2 diabetes, through poor diets and the absence of physical activities. Late-stage diagnosis as a result of either the avoidance of screenings or delays in high-risk individuals reduces the survival rate and makes the treatment even costlier. This can be solved through screening so as to detect cases early enough and offset the burden of disease in the long run (Kava, 2025). In Miami-Dade County, the primary care clinics represent the most significant access points to this population. However, the number of patients tends to circumvent the use of preventative care and follow-ups.

Evidence-Based Research Support

The current available evidence provided by the latest peer-reviewed literature demonstrates the effectiveness of nurse-led interventions in improving the assessment of enrolled colorectal cancer screening in different groups. It is constantly demonstrated in the literature research that when conducting patient education, the deployment of nursing professionals leads to increased awareness and compliance with the proposed preventive screening protocols (Glaser et al., 2024). Follow-ups, phone calls, and messaging are examples of reminder systems that will enhance additional patient involvement and improve screening rates of colorectal cancer. Culturally specific educational strategies are also applied to language, beliefs, and health literacy barriers and lead to the successful engagement of patients (Hashemi et al., 2022). This evidence adds to the incorporation of a structured nurse-based education program and establishes the role of nurses as the core of preventative health promotion.

Proposed Intervention

The proposed intervention is the adoption of a nurse-based education intervention program on colon-rectal cancer screening that would raise the screening rate in the primary care settings. As compared to the other program, this program has personal in-person education, provision of well-defined and culturally relevant printed materials, and following up with the patient on the phone to remind him or her of the involvement. It will also require qualified nursing staff, educational resources, and institutional resources in the actual clinic room and time to initiate it effectively (Han et al., 2025). The partners of the primary care providers, administrative nurses, and advanced practice nurses include the integration of the program into routine care. It is a practical intervention since it is cost-effective, unlike other interventions that may require a period of two years due to the planning, implementation, and evaluation stages.

Theoretical Framework / Nursing Theory

The Health Belief Model is a strong theoretical model as well, which forms a strong foundation of the project, since it details the impacts that individual conviction has on health-related actions and choices. This model highlights the perceived susceptibility, perceived severity, perceived benefits, and perceived barriers as significant factors that predetermine the readiness to engage in preventive health behavior of a person. This intervention improves patient awareness of the risks of colorectal cancer but overcomes the subconscious fears of the screening procedure because of the implementation of this framework. The approaches to educating or implementing education based on such a model will result in the reduction of perceived barriers and demonstration of the benefits of early detection (Oladunjoye & Valdez, 2025). The solution will help in patient-centered care and also improve the role that nurses can play to bring meaningful change in health behaviors.

Conclusion

Colorectal cancer screening is among the most pressing health issues, which needs attention of the general population due to its high morbidity, mortality, and health care spending in the United States. Despite the presence of the preventative measures, the proportion of individuals who continue to experience barriers to the timely screening and early diagnosis is very high. Nurse-led interventions offer viable and practical solutions that would promote the level of awareness, involvement, and screening rates among patients in the primary care units. The inequity can be minimized through social determinants of health by means of specific education to guarantee the equitable provision of preventive health care. Therefore, this capstone project will show how an evidence-based nursing practice is important in addressing issues in population health.

References

Glaser, K. M., Crabtree-Ide, C. R., McNulty, A. D., Attwood, K. M., Flores, T. F., Krolikowski, A. M., Robillard, K. T., & Reid, M. E. (2024). Improving Guideline-Recommended Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC): Implementing a Patient Navigation and Practice Facilitation Intervention to Promote Health Equity. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health, 21(2), 126–126. https://doi.org/10.3390/ijerph21020126

Han, Y., Han, Y., Huang, W., Liu, Y., Wang, Z., Zhao, W., & Zhang, W. (2025). Effects of nurse-led interventions on enhancing patient-related outcomes in colorectal cancer management throughout the cancer care continuum: A systematic review and meta-analysis. International Journal of Nursing Studies, 105100. https://doi.org/10.1016/j.ijnurstu.2025.105100

Hashemi, N., Bahrami, M., Tabesh, E., & Arbon, P. (2022). Nurse’s Roles in Colorectal Cancer Prevention: A Narrative Review. Journal of Prevention, 43(6). https://doi.org/10.1007/s10935-022-00694-z

Kava, C. M. (2025). Interventions to Increase Colorectal Cancer Screening Uptake in Rural Settings: A Scoping Review. Preventing Chronic Disease, 22. https://doi.org/10.5888/pcd22.250025

Oladunjoye, O., & Valdez, I. (2025). Improving Colorectal Screening Compliance Through Targeted Quality Improvement Interventions in Primary Care. Cureus. https://doi.org/10.7759/cureus.96031