A Patient Portal Tool, E-assist, for Supporting CRC Screening
Condition: Colorectal Cancer
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      To compare patient perceptions, intent to screen, and screening use among those using a
      patient portal with and without a colorectal cancer (CRC) screening decision support tool,
      e-assist.

      To evaluate whether the effectiveness of e-assist is moderated by multi-level factors,
      including patient health literacy, decision-making preference, and CRC screening decision
      stage.

      To assess program impact and create an implementation guide for e-assist by combining results
      from Aims 1 & 2, a program implementation analysis/process evaluation and the perspectives of
      staff from future diverse implementation sites including small primary care practices,
      University-based primary practices and federally-qualified health centers.
    

Detailed description: 
      During initial project period, the content was developed for the online e-assist tool using
      messages and tools developed under prior NCI-funded applications combined with newly
      developed messaging specific to this application. Throughout development, the principal
      investigator will seek input and guidance from a quality improvement team at the Henry Ford
      Health System (HFHS) (i.e., the local performance site) that is tasked with patient portal
      innovation for Meaningful Use. Once finalized, the effectiveness of e-assist will be
      evaluated using a three-arm, practical randomized trial.

      Trial participants will be randomized to one of the following three groups:

        1. e-assist: Colon Health (treatment arm) [n = 900]

        2. Healthwise Educational Program (active control) [n = 900]

        3. Usual care control (observational only) [n = 900]

      For the evaluation, the investigators employ an intent-to-treat design with primary
      effectiveness measured by electronic health record (EHR)-documented CRC screening use.
      Secondary outcomes of interest include patient-reported CRC screening intent, perceived
      barriers to and support for CRC screening as well as perceived susceptibility and screening
      benefits. Results from all analyses will be used to develop an implementation guide for the
      dissemination and implementation of e-assist among diverse primary care practices.
    

Intervention name(s): e-assist: Colon Health; Healthwise Educational Program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Online e-assist program uses educational messages and workflow tools. The intent is to reduce mental workload in terms of how to proceed by filtering and presenting information in a usable manner at a time of peaked situational awareness. The program will prompt patients to indicate their decision stage based on the Precaution Adoption Process Model. e-assist users are then prompted to view additional information and logistical assistance personalized for their decision stage.; Online access to fact sheets that provide basic information about colorectal cancer and screening.
Other intervention name(s): e-assist; treatment; experimental treatment; active control; usual care plus
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Health Services Research
Keywords: Colorectal Cancer Screening; CRC Screening; Rectum; Colon; Screening; Populations at Risk; CRC; colorectal cancer (CRC)