Simultaneous Improvement in Colon Cancer Screening Rates and Patient-Centered Care
Condition: Colon Cancer
MeSH terms: Colonic Neoplasms
Study type: Interventional

Summary: 
      Several screening methods exist to screen patients for CRC ranging from invasive (i.e.,
      colonoscopy) to less invasive (i.e., testing the stool for blood). Although choice between
      screening methods is recommended, patients are not currently offered an unbiased choice and
      physicians generally recommend only colonoscopy. In this project, the investigators will
      answer the following questions: 1) Is it feasible to incorporate a DA in the AHP protocol?;
      2) Is it feasible to incorporate mailing patients a stool blood test?; 3) Does the DA change
      CRC screening decision quality, using proxy measures such as knowledge and intent; and 4)
      Does the DA change the proportion of participants that complete a CRC screening test? To
      answer these questions the investigators will compare survey responses and CRC test type
      completed between two AHP CRC surveillance patients groups - those that received usual care
      versus those that received the DA.
    

Detailed description: 
      At the University of Colorado Hospital primary care clinics, only 59% of eligible patients
      are up to date with current colorectal cancer (CRC) screening. This is below the national
      average of 65% and well below the healthy people 2020 goal of 70.5%. Several screening
      methods exist to screen patients for CRC ranging from invasive (i.e., colonoscopy) to less
      invasive (i.e., testing the stool for blood). Although choice between screening methods is
      recommended, patients are not currently offered an unbiased choice and physicians generally
      recommend only colonoscopy. Further, the investigators know from research that choice
      increases screening rates. Unfortunately, many people do not follow through when only
      colonoscopy is offered. However, participants in one study were nearly twice as likely to be
      screened if they were offered a choice between colonoscopy and fecal occult blood testing
      rather than being offered colonoscopy alone. Thus, in this project, the investigators aim to
      examine the feasibility of incorporating a patient decision aid (DA) for patients in CRC
      screening surveillance with the Ambulatory Health Promotion (AHP) using a pre/post design.
      The investigators will answer the following questions: 1) Is it feasible to incorporate a DA
      in the AHP protocol?; 2) Is it feasible to incorporate mailing patients a stool blood test?;
      3) Does the DA change CRC screening decision quality, using proxy measures such as knowledge
      and intent; and 4) Does the DA change the proportion of participants that complete a CRC
      screening test? To answer these questions the investigators will compare survey responses and
      CRC test type completed between two AHP CRC surveillance patients groups - those that
      received usual care versus those that received the DA.
    

Intervention name(s): Decision Aid for Colon Cancer Screening; Usual Care Outreach for Colon Cancer Screening
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Paper decision aid describing different screening options for colon cancer; Patients overdue for colon cancer screening are contacted and outreach is performed in an effort to schedule colonoscopy
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary purpose: Screening