Genetic evidence for a causal role of depression in late-onset Alzheimer disease: A Mendelian randomization study.

Timely and consistent screening is critical for reducing morbidity and mortality from colorectal cancer (CRC) [], but rates remain low, particularly for people residing in rural communities [, , ] and for those receiving Medicaid coverage [, ]. Common barriers to completing colonoscopy, an effective CRC screening modality, include inability to take time off from work, lack of transportation, stigma, and hesitancy about bowel preparation [, ]. Prior research has shown that some of these barriers are more common in rural areas and for Medicaid enrollees with lower incomes []. Mailed fecal immunochemical testing (FIT) and patient navigation for follow‐up colonoscopy have been shown to increase screening rates by addressing some of these known barriers []. A pilot study conducted by our team, which was a partnership between academic researchers, a community‐based organization, a Medicaid health plan, and primary care clinics, found that mailed FIT was feasible and acceptable for these organizations and supported CRC completion []. The study additionally highlighted a need for navigating patients to the follow‐up colonoscopy after abnormal FIT. Combining mailed FIT with patient navigation has also been supported by microsimulation modeling [] and a systematic review []. While mailed FIT and patient navigation can reduce patient‐level barriers to CRC completion, the logistical coordination necessary for these programs is substantial and poses barriers, especially for smaller, rural clinics [, ]. For example, population‐based reporting to identify those due for CRC screening can be challenging in primary care clinics with fewer central staff and limited electronic health record (EHR) capabilities [, ]. Partnering with health plans has been shown to help overcome these barriers when health plans cover the cost of mailing and support patient identification and vendor coordination; however, this model was previously tested in urban settings and with larger clinic populations [, ].