Increasing Colorectal Cancer (CRC) Screening In Primary Care
Condition: Colorectal Cancer Screening
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      Colorectal cancer screening remains lower than optimal. The purpose of this study was to test
      the efficacy of phone-based motivational interviewing versus tailored communication versus
      usual care in increasing CRC screening in primary care clinics.
    

Detailed description: 
      Regular screening reduces both morbidity and mortality from colorectal cancer (CRC).
      Screening rates, however, remain low suggesting the need for innovative research designed to
      increase screening behavior. The purpose of this study is to compare the effectiveness of two
      interventions (Tailored Health Communication [THC] and Motivational Interviewing [MI]) in
      increasing CRC screening behavior. Both interventions are based on a strong conceptual
      framework derived from the Health Belief Model (HBM) and Transtheoretical Model (TTM),
      allowing us to explore the underlying mechanisms through which these interventions impact
      behavior change.

      The primary aim of this study is to compare CRC screening test use among 804 participants
      randomly allocated to control or intervention conditions; participants will be recruited from
      the two sites (Chicago, IL, and Nashville, TN). The 3 study groups will receive (1) standard
      care, (2) tailored health communication, and (3) motivational interviewing. Eligibility
      criteria for study participants includes being 50 years or older, not having CRC, and being
      of average or moderate risk for CRC. Study participants will be surveyed by telephone about
      CRC-related beliefs pre-intervention (Time 1), 1 month postintervention (Time 2), and at 6
      months postintervention (Times 3 and 4, respectively). Dichotomous behavioral outcomes (had
      screening test or not) and stages of CRC screening test adoption (based on the TTM) will be
      assessed, as well as sociodemographic and belief predictors of screening behavior. Binomial
      and multinomial logistic regression models will be used to evaluate screening test use and
      stage of test adoption. Sociodemographic and belief variables will be used as covariates,
      with intervention group as the primary independent predictor. Descriptive statistics and
      ANOVA will be employed to assess between intervention differences in amenable beliefs. Path
      (mediation) analysis will be performed to further explore the underlying mechanisms through
      which THC and MI may differentially affect CRC screening behavior.
    

Intervention name(s): Tailored counseling; Motivational Interview
Intervention type(s): Behavioral; Behavioral
Intervention description(s): education tailored to baseline beliefs by trained counselor over phone; motivational interview by trained MI counselors by phone
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Screening
Keywords: colorectal cancer screening; tailored education; motivational interview; patient education