De-implementation of Outdated Colonoscopy Surveillance Interval Recommendations Among Patients With Low-risk Adenomas

Study Overview
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Brief Summary
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The purpose of this study is to compare the effectiveness of three standard of care outreach approaches (i.e., mailed letter, secure message, and telephone call) on patient adoption of the new 10-year colonoscopy surveillance interval recommendation for a random sample of health plan members who have a now-outdated 5-year surveillance interval due to a finding of 1-2 small adenomas at their prior colonoscopy. The primary study endpoint is the proportion of patients in each outreach arm who adopt the new 10-year colonoscopy surveillance interval.

Official Title
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De-implementation of Outdated Colonoscopy Surveillance Interval Recommendations Among Patients With Low-risk Adenomas

Conditions
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Polyp of Colon

Intervention / Treatment
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* Behavioral: Outreach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Kaiser Permanente Northern California (KPNC) membership>12 months Primary medical center is either KP San Rafael, KP San Francisco, KP San Leandro, or KP Walnut Creek 54-70 years of age at time of 5-year surveillance colonoscopy interval A baseline colonoscopy with a finding of 1-2 small tubular adenomas and are due for their 5-year surveillance procedure in 2022 Average risk for CRC A valid mailing address, kp.org account (i.e., KPNC's secure messaging portal), and telephone number at time of study enrollment. Exclusion Criteria: More than 12 months of membership prior to index colonoscopy, and indications that would make an individual above average risk for CRC, such as: adenoma with advanced histology on colonoscopy, adenoma >10 mm on colonoscopy, family history of CRC, prior history of colonoscopy, prior history of adenomas or colon polyp diagnoses, history of IBD, history of hereditary polyposis syndrome, 3 or more adenomas, adenoma 10 mm in size or greater, adenoma with advanced histology, and any sessile serrated polyp or traditional serrated adenoma

Ages Eligible for Study
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Minimum Age: 54 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Mailed Letter<br> | Behavioral: Outreach<br>* Mailed letter, secure message or telephone outreach will be used depending on arm enrolled<br>|
| Active Comparator: Secure Message<br> | Behavioral: Outreach<br>* Mailed letter, secure message or telephone outreach will be used depending on arm enrolled<br>|
| Active Comparator: Telephone Outreach<br> | Behavioral: Outreach<br>* Mailed letter, secure message or telephone outreach will be used depending on arm enrolled<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients who respond with a 10-year surveillance interval change |  | 2 months following outreach intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients requesting a physician appointment |  | 2 months following outreach intervention |