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CRC Awareness Month: An Interview with Mindy Conklin at Hitting Cancer Below the Belt

Christine Regan
March 18 2026
Christine

Christine Regan, Digital Health Technology Advisor

christine.regan@mpathhealth.com

Key Takeaways:

  1. There are many people in our communities who can’t afford health insurance, but don’t qualify for Medicare or Medicaid. These patients face serious barriers to accessing CRC screening.

  2. Many non-profits offer small one-time grants for CRC screening and prevention work, but that model isn’t sustainable. HCB2 focuses on long-term, consistent support.

  3. The reasons people might be resistant to screening may surprise you. It’s important to listen and be willing to find innovative solutions to help patients get screening.

  4. Saving lives by increasing cancer screening takes a community. It’s important to collaborate and learn from others about what works.

 

During Colorectal Cancer Awareness Month, one thing is clear: awareness alone isn’t enough.

Despite growing attention, colorectal cancer screening rates remain unacceptably low—especially among uninsured and underserved populations.

In this conversation, mPATH Health’s Christine Regan speaks with Mindy Conklin, Founder of Hitting Cancer Below the Belt (HCB2), about what it really takes to move patients from awareness to action—and why navigation, not just access, is the missing link.

 

Christine: Thank you, Mindy Conklin, for joining me today for Colorectal Cancer Awareness Month. Your passion and the work you’re doing with Hitting Cancer Below the Belt continues to impress me, and I’m constantly learning from you.

Mindy Conklin: Very kind. Thank you.

Christine Regan: Let’s dive right in. Why did you form Hitting Cancer Below the Belt?

Mindy Conklin: I never worked in the non-profit space before. Unfortunately, my husband was diagnosed with stage 4 colorectal cancer in 2009. He had no signs or symptoms that we knew of and no family history. At the time, in 2009, it was very odd to have him diagnosed stage 4 at age 41. That's no longer odd. Unfortunately, that's common now, but it was not common then. He passed away in 2011 after battling for about 16, 17 months.

When he passed, I resigned from my career and decided that nobody was talking about this disease enough, not knowing at the time that, the wave of early onset of colorectal cancer was coming our way. So here we are now, colorectal cancer is the number one cause of cancer-related death in people under the age of 50, men and women-- young men and women -- under the age of 50. I started the organization just to raise awareness, and to be honest with you, I can't stand the word awareness. I don't think there's action behind it. I think it's a good start, a small baby step, but we need to do more. We try to move people from awareness to action and to overcome the many misconceptions people have surrounding this disease.

Christine Regan: Do you find that there are challenges to moving from awareness to action?

Mindy Conklin: There are quite a few challenges. There is a lot of silence around this disease. People don't want to talk about it. 15 years later we are still fighting to make sure people have access to screening, especially the folks that are at higher risk. We started with the free clinics and that has remained our focuss since the beginning. We work with the underserved community through the free clinics, and some FQHCs [federally qualified health centers] as well. We work with people who don't have insurance and don't qualify for Medicaid.

It’s important that people don’t slip through the cracks. There are lots of people in our community that are well below the federal poverty limit and unable to afford insurance for themselves and for their family. We currently fund 18 colorectal cancer screening programs at free clinics or FQHCs across the state of Virginia, and we have an array of educational initiatives and other types of screening. There are several programs and services that we offer to make sure that we get people screened in a timely fashion.

Christine Regan: That’s a good segue to my next question. What makes your approach to this work different than other organizations? Why do you think you’re so effective?

Mindy Conklin: I think we listen really well. We don’t follow trends. We follow data. We want to make sure everything we’re doing is based on the best practices and research. But we also ask: what’s not being done? Where are the gaps?

For instance, a lot of our free clinics and FQHCs, especially FQHCs, are getting FIT kits from various organizations now. That’s not novel like it was back in 2014 and 2015 when we started doing it. But what may not be supported are all the navigational needs. Free clinics don’t have navigators. They may have a community health worker, maybe. These programs need a clear strategy: What’s the incentive? What’s the return rate? What’s the screening rate? What else can we do? What are we missing?

Every clinic’s different. Every area is a little bit different, so it’s really about building relationships with our free clinics and staying in contact with them.

We’re not one-hit wonders. We don’t come in and say, “Hey, we have a little bit of grant money, let’s try this for a year,” and then leave. If we’re going to do something, we have to continue to find funding for it, and we need to build trust with our safety-net partners so they can count on us. I think that’s what makes us different. We try to be consistent. We evolve the programs, but we remain consistent and fill in the gaps with what’s not being done. We’re there, whether it’s in-person boots on the ground or making ourselves really available via other channels to support our partners.

Christine Regan: Your approach is so different in that sense. I agree with the whole notion of flying in with a bag full of money or an idea, and then that’s it. But then, what happens after that? I love that you say, “We’re here to stay.” We’re not just going to come in and drop some fairy dust and hope it works.

Mindy Conklin: Exactly. We do believe that access is the main issue, but I also understand the argument that just because you have access doesn’t mean you’re going to get screened. For folks who have insurance, I think the screening rate is around 65–70%. So, access alone doesn’t guarantee screening.

But when you look at free clinics and FQHC screening rates, they’re down in the 20s, maybe the 40s in some places. It’s clear access means something. Offering a service so people can get the medical care they need is extremely important.

Christine Regan: When you talk about hard-to-reach patients, is your reasoning that it’s mainly access? Or geography, insurance? What makes someone “hard to reach”?

Mindy Conklin: My main question when people are really hesitant about screening and saying things like “I’m not getting that test,” is: “In a perfect world, what would have to happen for you to get screened?” I asked this of a patient recently in a really rural area of Virginia, Clinch River, and I thought he would say, “I can’t afford it” or, “I need someone to drive me,” but instead, he said, “I don’t want to wear a diaper.” That was surprising.

I asked, “Wear a diaper?” He said, “If I get screened, I’ve got to get a colonoscopy. There are no bathrooms between here and the place I’d have to go, about an hour away. I’m going to have to use the bathroom alongside the road. I’m not doing that.” If I hadn’t asked that question, I would never have known.

I wouldn’t want to do that either. The breakthrough happened when I asked the right question. Now I know that a barrier to overcome in that area is that patients have to travel a long way, in very rural areas, to get secondary or advanced care. This is the kind of information I want when we move into different areas

Another example that comes to mind from our educational or tabling events is that some people come by and say, “Oh, I don’t need you. I get screened every five or ten years. It’s great. No problem.” I love those people, because I say, “I do need you. I need you to tell as many people as possible your story. Make my work easier, please.” I get them involved in the conversation.

Everyone who comes by the table gets approached in different ways based on what they present, but you can’t be the one who tells them what they should be doing. You have to keep your mouth shut and let them talk. That’s one of the fun parts of being out in the community: you never know who will walk by your table. It’s fun and exciting.

We also get survivors involved. We have a small survivor group of about 10 people. We want to amplify their message and their story, give them a platform, and honor the work they are doing. We meet, do luncheons twice a year—that’s their focus, because most survivors want to “do something.” I tell them, “You have a story that needs to be shared. Let’s do that.”

Christine Regan: I want to follow up on the man with the diaper. You said that story tells you a lot about that population of people who have to drive an hour or more for screening. So my question is: what can you do?

Mindy Conklin: There is something we can do. We track this kind of information. If we see this consistently, we can go for grants to help pay for hotel costs and transportation.

We ask, “why can’t we do that?” A hotel costs maybe $150 a night? What is that in the grand scheme? For some folks who need a diagnostic colonoscopy, average risk, no bloody stools or family history. You start with a stool-based screening test, and if it’s positive, you help them get that colonoscopy. A gas card and a $150 hotel room could make that possible and is a small change when you consider the cost of advanced cancer treatment.

We have a partner who’s fantastic and helps us with incentives and transportation. We don’t have a line-item budget for hotel costs yet, but who’s to say we can’t write that in? Since we’re grassroots, it doesn’t take six months to a year of strategic planning and layers of approval. If we see it’s a continued need, we can respond.

Christine Regan: I love that thought process. It’s like what we heard in Alaska from several tribal consortiums and other groups there. Until I saw Alaska superimposed on a map of the United States, I didn’t realize how far apart places are.

Their number one barrier is similar: there’s a place in Anchorage that facilitates overnight stays for treatment, which is great, but some people can’t get there. So, it’s a two-part problem: they have a place to stay, but how do they get there? This isn’t unique to Clinch River. Rural areas in general face this.

Mindy Conklin: Exactly. In that rural region of Virginia I mentioned, there are many counties like that. The American Cancer Society still has programs where people can apply for support to stay near the treatment center. The concept we’re talking about falls right in line with that.

Christine Regan: We’ve talked through a lot of roadblocks for free clinics and FQHCs- workflow, lack of navigation, funding. Are there specific areas where you find it really hard to move the needle, despite your efforts?

Mindy Conklin: I’ve been thinking about this. We just had a team meeting today for the Virginia Colorectal Cancer Roundtable (VCCRT) and we were talking about hot spots. We’re nationally known to have two in Virginia: southwest, which I just mentioned, and the Tidewater/Eastern Shore area. We’re not currently in much of southwest, so that’s an area we’d like to get into.

Christine Regan: When you identify hot spots, how do you do that?

Mindy Conklin: Through national data—The American Cancer Society has great resources and tools like the GIS mapping work by Dr. Sahar, the Screening Atlas. It’s very visual. You can pull up states, select a cancer type, and drill into each FQHC to see the data. I’m a visually-oriented person, so I love the graphics.

Christine Regan: The ACS Atlas is so helpful. We’ve talked a lot about the issues, problems, barriers that still exist. I’d like to move to something hopeful. If you had additional resources, what do you think could help you move the needle on this CRC control and prevention?

Mindy Conklin: You’re going to think it’s silly, but we consider ourselves a colon health, colorectal cancer prevention nonprofit. Yes, timely screening is critically important, but how about we give the gut a little love? The large intestine, the colon, is an incredibly important organ.

Hippocrates, the father of medicine, said, “All disease begins in the gut.” If we claim we’re lovers of the colon because we want people to be spared from getting or dying from colon cancer, why aren’t we talking more about how to keep the colon healthy? That’s prevention.

Colorectal cancer is now the number one cancer killer in young people. I don’t expect the ER doctor who treats my broken leg to know everything about gut health. He’s an expert in fixing my leg. Likewise, colorectal surgeons and GI specialists are in their lane, but there are other lanes we’re not bringing in that we should. It’s important to hear from people with expertise in nutrition, the gut microbiome, fighting inflammation, and practical and healthy living if we want to make an impact on preventing the disease in the first place.

Christine Regan: Different approaches and messages resonate with different people. I think what you’re saying is that you have to meet people where they are and not ignore the foundational prevention aspects of the mission.

Mindy Conklin: Right. To circle back, that’s one thing I think needs to happen: the conversations need to start. We’ve dipped our toe into that pool by saying “food is medicine,” and that’s a good start.

The last thing I’ll say is this: how many times do we say, “Hey, how are you?” or, to friends and loved ones, “Did you sleep well?” Why can’t we ask, “How are your bowel movements this week?” It actually says a lot. Gut health is connected to overall physical and mental health.

Christine Regan: Normalizing it is huge as an overall takeaway. Lastly, we’ve talked about some things you’ve seen work. Within your partner clinics or FQHCs, is there something they did that was very effective-something you wish you could replicate?

Mindy Conklin: The Southeastern Colorectal Cancer Consortium is a beautiful example. They meet every year, and I love this group because they talk a lot about a special kind of R&D, rip off and duplicate. It’s all about sharing openly and proliferating strategies that work. They ask, “What are you doing that’s innovative?” Those are the speakers each year, and they say, “R&D this, guys.”

Navigation comes up repeatedly. We’ve got friends in South Carolina whose entire nonprofit is navigation. They provide navigators for underserved community clinics, which is amazing. Navigation is key.

Because of that, we’ve connected with the Virginia Association of Community Health Workers. Shantini Jackson is amazing. She trains community members to be CHWs. The training is lengthy (maybe a year or longer) and offers great support and information.

That’s what we need: engage community members, especially in rural areas, and get them involved as community health workers or volunteers. Many people want to volunteer or work, and if you’re working as a CHW, you should be paid. Engaging the community helps the clinics. Again, it all goes back to relationships. Relationships are key.

Christine Regan: The AI agents have a place in the healthcare ecosystem in terms of providing and organizing information, but they can’t replace real human connection. mPATH uses AI in to organize and present information, but we continue to be big supporters of live human navigators. Personal connections are irreplaceable.

Mindy Conklin: Exactly. If we rely on technology too much, it edges out opportunities to have human to human conversation or relationships. Those are critical to building understanding. But technology and a human touch can live in the same space. We just have to figure out how they blend.

I know for a fact that one reason Hitting Cancer Below the Belt has been able to evolve, grow, and make an impact is because of relationships.

Christine Regan: In the last few minutes, are there any organizations you’d like to give a shout‑out to? There are so many great organizations fighting with you for this cause like FIGHT CRC, Colorectal Cancer Alliance, ACS Roundtable, and other nonprofits—and I’d like to call them out as well.

Mindy Conklin: I would include Exact Sciences, if they’re not already on your list. Other amazing organizations include: The Red Gates Foundation, the University of Virginia (UVA), VCU Massey Comprehensive Cancer Center, The Prevent Cancer Foundation, and Sentara.

Christine Regan: What a great list of organizations. We look forward to seeing you at SE CRC Consortium in April. I really appreciate your time today and getting to know you better.

Mindy Conklin: Okay, thanks. I appreciate the opportunity.

Christine Regan: Have a great day!

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Hitting Cancer Below the Belt & mPath Health are proud to stand alongside a powerful community of partners and allies who are all working in different but complementary ways to advance prevention, improve access, and support patients and families.

 

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