Testing Interventions to Motivate and Educate
Condition: Colorectal Cancer
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      This study is being done to see if teaching physicians and people who are at least 50 years
      old and have not been screened within guidelines for colorectal cancer about the importance
      of colorectal cancer screening will increase screenings for colorectal cancer. The
      researchers want to understand what ways will work best to motivate and educate both patients
      and the doctors and nurses who care for them.
    

Detailed description: 
      Colorectal cancer (CRC) is the third leading type of cancer and the third leading cause of
      cancer death in the United States. This study focuses on improving CRC screening in The Ohio
      State University Primary Care Network (OSUPCN). Ohio has higher than average rates of CRC
      mortality compared to the rest of the US. The study population for this study will also
      include minority and older individuals as these groups have higher CRC incidence and
      mortality rates.

      The goal of this study is to test a program to improve CRC screening among male and female
      patients over the age of 50 in 10 primary care clinics. This study will use physician
      surveys, focus groups and a community advisory board to finalize the content of the
      interventions. Five theoretical models form the theoretical framework of the study - the
      health belief model, social networking, minority health communications model, PEN III, and
      the transtheoretical model. The interventions will be directed at the clinic and patient
      levels, and will be tested in a randomized design. Five clinics will receive the clinic plus
      patient-directed interventions and 5 clinics will be randomized to usual care. The clinic
      intervention will consist of provider, system and waiting room activities. The
      individual-directed intervention will include three stepped stages for patients who have not
      yet been screened: (1) a tailored physician letter, easy-to-read educational materials about
      CRC and an FOBT information sheet and card; (2) follow-up telephone barriers counseling for
      patients who do not complete CRC screening after receiving the letter; and (3) in person home
      visits by lay health advisors (LHA) for those who do not complete CRC screening after
      receiving the first two interventions. Research staff will conduct a process evaluation of
      the interventions to identify problems in implementing them and determine the extent to which
      each of the components is successfully carried out. They will also examine how components of
      the intervention relate to the theoretical frameworks used to motivate CRC screening
      completion. If successful, this program can easily be adapted for use by primary care
      practices and clinics to improve CRC screening.
    

Intervention name(s): Clinic-directed intervention program; Individual Patient-Directed Program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Clinic-directed intervention program: Subjects recruited at the Intervention Clinics will first be provided with Clinic-directed interventions including: 1)provider-directed interventions (computerized case-based education, evidence-based guidelines, ask the expert; 2)office-based systems (risk assessment forms, procedure monitoring, follow-up protocol, audit with feedback, chart reminders); and 3) waiting room materials.; If the subjects have not undergone colorectal cancer screening within 12 months of receiving the clinic-directed program, they will be provided with an individual patient-directed program consisting of the following stepped interventions: 1) tailored physician letter, easy-to-read educational materials, and an fecal occult blood test (FOBT)information sheet and card; 2) telephone counseling for those who do not respond to the letter; and 3) home visits by lay health advisors for those who do not respond to the letter or phone counseling.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Screening
Keywords: Colorectal Cancer; Screening; Education; Testing