A Sustainable Approach to Increasing Cancer Screening
Condition: Colorectal Cancer; Breast Cancer; Cervical Cancer
MeSH terms: Colorectal Neoplasms; Uterine Cervical Neoplasms
Study type: Interventional

Summary: 
      Parent study:

      A Coordinated Approach to Cancer and Health (CATCH), was designed to compare the efficacy of
      two intervention arms (described below) intended to increase breast, cervical, and colon
      cancer screening rates among patients served by community health centers. A central focus of
      CATCH is to evaluate sustainable strategies for maximizing cancer screening rates among
      populations facing significant cancer disparities.

      CATCH was conducted in partnership with the large health clinic in Massachusetts, which
      serves a largely Hispanic low income population. Focusing on the use of an Interactive Voice
      Response (IVR) telephone technology system, the study is examining the extent to which the
      IVR, when developed in a culturally sensitive and appropriate manner (focus groups will be
      conducted to inform the intervention), can improve breast, cervical and colon cancer
      screening rates compared to a control group. Furthermore, we plan to determine if pairing IVR
      with telephone calls from a prevention care coordinator (PCC) will result in higher screening
      rates (when compared to the IVR only group). We will determine the cost-effectiveness of IVR
      alone vs. IVR + PCC.

      Substudy:

      We conducted a substudy of the parent study, looking at a comparison of return rates of two
      colorectal cancer screening home test kits: Fecal Occult Bood Tests (gFOBTs) and Fecal
      Immunochemical Tests (FITs). As well we surveyed people who pick up one of these two types of
      tests to assess barriers and facilitators of returning the completed kit to the health center
      for assessment.
    

Detailed description: 
      For the substudy, the study objective was to:

      Determine if there is a difference in completion of a home blood stool test kit by type of
      home test being employed Fecal Occult Blood Test (gFOBT) vs. Fecal Immunochemical Test (FIT),
      and to determine predictors of test completion.

      Substudy methods/design/arms/eligibility:

      All patients who picked up a home blood stool test kit during the 6-12 month study
      recruitment time period were randomized to receive either a gFOBT or FIT kit. Randomization
      occurred by the month. Medical assistants (MAs) handed out the kits. Participants who picked
      up a kit (either gFOBT or FIT) were given a study information card that briefly described the
      study and had a study opt out phone number on it. If patients did not call and opt out, the
      card let the patient know that he/she would be contacted via telephone to complete a brief
      survey, for which they were given a small incentive upon completion.

      A bilingual member of the study staff telephoned individuals, who had not opted out, who
      picked up a home blood stool test kit during the study period. Four to six weeks post kit
      pickup, staff determined if the patient had returned a completed test to the clinic (yes vs.
      no) by examining the electronic medical record. This information- whether a patient had/had
      not returned a completed test was used to tailor some questions asked on the survey. Study
      staff obtained verbal informed consent before survey administration. Participants who cited
      that time was a burden stopping them from starting the survey were offered an abbreviated
      version of the survey.

      This study was limited to age eligible patients who picked up a home colon cancer screening
      kit.
    

Intervention name(s): IVR only; IVR+PCC
Intervention type(s): Behavioral; Behavioral
Intervention description(s): As noted, patients in this arm receive consistent, but spaced out calls generated by an interactive voice response system reminding them of breast, cervical and colon cancer screenings needed, as applicable.; Interactive voice response calls followed up by prevention care coordinator calls for those who do not respond to IVR
Allocation: Randomized
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Screening
Keywords: screening; cancer prevention; IVR