Levity as a tool for difficult conversations: Healthcare provider experiences with the Butts & Badges colorectal and anal cancer awareness initiative in community health centers.

107 Background: Colorectal & anal cancer conversations remain challenging in healthcare settings. The 'Butts & Badges' program is a comprehensive awareness initiative targeting patient-facing staff (front desk to providers) across clinical departments of community health centers. The program is premised on wearing a conversation-starting lapel pin (a heart that also look like a butt) combined with pre-implementation education, talking point reference guides & patient educational materials. This multi-component approach uses levity to normalize cancer discussions and reduce communication barriers. This study evaluated healthcare staff experiences implementing this approach. Methods: We conducted a qualitative evaluation using semi-structured interviews with staff from community health centers that participated in our March 2025 pilot program. The program distributed comprehensive awareness kits for over 700 patient-facing staff. Interview protocols explored implementation barriers, facilitators, patient responses, staff confidence changes, and suggestions for improvements. Responses were analyzed using thematic analysis to identify key themes and recommendations for program improvement. Results: Preliminary analysis of responses from representatives of 3 FQHCs across 2 states (California and Texas) revealed four key themes among participating staff (n=6 respondents representing their larger clinic teams). Conversation facilitation: Most staff reported the comprehensive toolkit significantly eased initiating colorectal cancer discussions, with patients frequently asking about the pins first. Stigma reduction: The "cheeky" approach normalized typically uncomfortable topics, with staff noting increased patient engagement across departments. Implementation challenges: The primary barrier was staff forgetting to wear pins consistently, though the pre-launch education and reference guides were highly valued. Enhanced confidence: Staff felt the multi-component approach reduced anxiety about screening discussions while maintaining professionalism. Expansion opportunities: Suggestions included integrating materials with routine care processes (stool-kit disbursement), developing outreach campaigns for non-clinic patients (mailers), and offering "cheeky" incentives for completed screenings. Data aggregation and final analysis are ongoing. Conclusions: Multi-component levity-based awareness programs show promise as effective tools for sensitive health topics across healthcare departments. Preliminary findings suggest this comprehensive approach reduces communication barriers while maintaining clinical appropriateness. Final results will inform strategies for scaling culturally appropriate cancer awareness programs in diverse healthcare settings.