Clinical trial NCT00441311: Dissemination of Colorectal Cancer Screening to Primary Care Physicians
Official title: Dissemination of Colorectal Cancer Screening to Primary Care Physicians
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Colorectal Cancer
Keywords: colorectal cancer screening
primary care physicians
health disparities
stratified randomized clinical trial
Lead sponsor: Columbia University
Sponsor class: OTHER
Collaborators: name: American Cancer Society, Inc.
First posted: 2007-02-28
Enrollment: 264
Sex: ALL
Minimum age (years): 50
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SCREENING

Brief summary: The aim is to assess the efficacy of an intervention, academic detailing, a brief, frequently repeated educational program, on increasing recommendations for colorectal cancer screening among primary care providers by comparison to a service-as-usual control. The study is a stratified randomized clinical trial of primary care physicians, stratified by distinct urban communities in the New York metropolitan area. The primary outcome is colorectal cancer screening recommendations measured via medical audit at 12-month followup after randomization.

Detailed description: The purpose of the present study is to adapt and extend the use of academic detailing to the dissemination of colorectal cancer (CRC) screening findings and guidelines to primary care physicians practicing in selected geographic areas in New York City. Since improving implementation of cancer screening guidelines also involves compliance by patients in completing the recommended tests or examinations, we will also seek to assess knowledge, attitude and screening behaviors of patients visiting primary care practitioners in our sample. Our long-term goal is to reduce colorectal cancer mortality among ethnic and racial minorities, by influencing the screening behaviors of their primary care physicians.

The specific aims of the study are as follows:

* Aim 1. To test the hypothesis that an intervention, multi-component academic detailing, will increase the rate of physician CRC screening at 3and 6month postrandomization, compared to the rate observed in a serviceasusual control.
* Aim 2. To develop models predicting which physician offices are most and least likely to adopt the intervention, and to generate hypotheses about tailoring the dissemination of CRC screening guidelines to different physician subgroups.
* Aim 3. To conduct cost-effectiveness analysis comparing the incremental societal costs and effects (in lives saved, life-years saved, and quality-of-life-years saved) of the CRC intervention implemented in physicians' offices.

Eligibility criteria: Inclusion Criteria:

* Devote at least 50% of their practice to primary care
* Work in the study communities
* Are non-hospital based community practitioners
* Have no immediate plans to retire or to leave their practice.

Exclusion Criteria:

* Specialty physicians
* Intend to retire or otherwise leave practice over course of the study
* Other conditions that would preclude meaningful participation
* Not working in study communities

Primary outcomes:
measure: Colorectal cancer screening recommendations
timeFrame: Up to 12 months from the time of randomization
Secondary outcomes:
Other outcomes:
Locations:
city: New York
country: United States
facility: Columbia University Medical Center
state: New York
Study officials:
affiliation: Columbia University
name: Sherri Sheinfeld Gorin, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Honda K, Gorin SS. A model of stage of change to recommend colonoscopy among urban primary care physicians. Health Psychol. 2006 Jan;25(1):65-73. doi: 10.1037/0278-6133.25.1.65.