Multilevel Action Toward Colorectal Cancer and Hepatitis C Education and Screening (MATCHES): Study protocol for a hybrid 1 stepped-wedge multibehavioral randomized trial

BACKGROUND: The current paper describes the protocol for the Hybrid type 1 effectiveness-implementation trial titled Multilevel Action Toward Colorectal Cancer and Hepatitis C Education and Screening (MATCHES). The aims of the MATCHES intervention trial are to promote both colorectal cancer (CRC) and hepatitis C virus (HCV) screening among patients aged 45-75 years old receiving primary care at a federally qualified health center (FQHC) who are not currently up-to-date with both screenings and to examine implementation outcomes. METHODS: Ten health center sites in the FQHC will be randomized in two waves using a stepped wedge design. Intervention strategies target the system, clinician, and patient levels. System-level strategies include a customized electronic health record best practice alert that pairs CRC and HCV screening and standard operating procedures. Clinician-level strategies include a training session and feedback on screening rates. Patient-level strategies include a theory-informed educational booklet about CRC and HCV screening in English or Spanish and access to stool DNA testing and HCV screening among 350 participants. The primary outcome is both CRC and HCV screening uptake at 12 months post-intervention among 350 participants. System-wide CRC and HCV screening rates among patients 45-75 years old also will be monitored. Implementation barriers and facilitators will be examined. RESULTS: The project is ongoing; effectiveness and implementation outcomes will be determined following study completion. CONCLUSIONS: Results may inform potential subsequent scale-up and offer insights for promoting multiple screening behaviors in a single intervention. CLINICAL TRIALS IDENTIFIER: NCT06745895 (date registered: 2024-12-20); https://clinicaltrials.gov/study/NCT06745895?cond=CRC%20AND%20HCV&rank=.