Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers

Baker, David W.; Brown, Tiffany; Goldman, Shira; Liss, David T.; Kollar, Stephanie; Balsley, Kate; Lee, Jun-Young; Buchanan, David

doi:10.1007/s10552-015-0650-0

Cited by 28 publications

(29 citation statements)

References 9 publications

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“…In a small, year 2 follow-up study (N = 124) with EHR-generated reminder letters, mailed FOBT kits, automated phone calls or text, and if needed, a personal phone call, an impressive 89% of participants completed a second FOBT. 32 This study suggests EHR records may facilitate continued screening and that FOBT completion may be aided with automatic calls (and may not require a clinic visit or personal call). However, it is not known if automated calls or texts would be effective in non-urban areas.…”

Section: Discussionmentioning

confidence: 93%

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Third Annual Fecal Occult Blood Testing in Community Health Clinics

Arnold¹,

Rademaker²,

Wolf³

et al. 2016

Am J Hlth Behav

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Objectives Our objective was to determine the effectiveness of 3 approaches to encourage completion of fecal occult blood testing (FOBT) in the third year of the intervention. Methods Between 2008 and 2011, a quasi-experimental intervention was conducted in 8 predominantly rural Federally Qualified Health Centers. Clinics were randomly assigned to enhanced care (screening recommendation and FOBT kit mailed annually), education (patients additionally received a health literacy appropriate pamphlet and simplified FOBT instructions), or nurse support (same as education but with nurse follow-up). Participants included 206 patients with negative FOBTs in years 1 and 2; ages 50–85, 80% female, 70% African American, and 52% had limited health literacy. The main outcome measure was completion of a third annual FOBT. Results Third-year FOBT rates were 48% overall, 34.2% enhanced care, 59.6% education, and 47.4% nurse support (p = .21), even after adjustment for sex, marital status, and health literacy. Conclusion All mailed interventions were similarly effective in sustaining rates of FOBT screening. Post hoc analyses of the results analyzed by health literacy skills found that patients with both limited and adequate health literacy skills were more likely to complete FOBTs when mailed simplified instructions.

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Section: Discussionmentioning

confidence: 93%

“…7,8,25–31 Mailed FOBT kits with reminder letters and telephone calls have been effective in promoting initial and repeat screening in predominantly Spanish-speaking patients in an urban FQHC. 32 …”

mentioning

confidence: 99%

Third Annual Fecal Occult Blood Testing in Community Health Clinics

Arnold¹,

Rademaker²,

Wolf³

et al. 2016

Am J Hlth Behav

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“…In community health center settings, Baker et al found that, compared with usual care (computerized reminders, standing orders for home FIT distribution by medical assistants, and clinician feedback on CRC screening rates), patients in an intervention group that also received a mailed reminder letter, a free FIT with low‐literacy instructions, a postage‐paid return envelope, and automated follow‐up telephone and text messages were much more likely than those in usual care to complete screening with a stool test (82.2% vs 37.3%; P < .001) . After 2 years of follow‐up, 71.6% of the intervention group remained fully up to date with CRC screening . Several organizations have compiled valuable resources to facilitate the implementation of multifaceted interventions to increase uptake of and adherence to CRC screening (see Supporting Information).…”

Section: Options For Crc Screeningmentioning

confidence: 99%

“…203 After 2 years of follow-up, 71.6% of the intervention group remained fully up to date with CRC screening. 204 Several organizations have compiled valuable resources to facilitate the implementation of multifaceted interventions to increase uptake of and adherence to CRC screening (see Supporting Information).…”

Section: Interventions To Increase Utilization and Adherencementioning

confidence: 99%

Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society

Wolf

Fontham

Church

et al. 2018

CA A Cancer J Clinicians

1,509

1,108

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In the United States, colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. For this guideline update, the American Cancer Society (ACS) used an existing systematic evidence review of the CRC screening literature and microsimulation modeling analyses, including a new evaluation of the age to begin screening by race and sex and additional modeling that incorporates changes in US CRC incidence. Screening with any one of multiple options is associated with a significant reduction in CRC incidence through the detection and removal of adenomatous polyps and other precancerous lesions and with a reduction in mortality through incidence reduction and early detection of CRC. Results from modeling analyses identified efficient and model-recommendable strategies that started screening at age 45 years. The ACS Guideline Development Group applied the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria in developing and rating the recommendations. The ACS recommends that adults aged 45 years and older with an average risk of CRC undergo regular screening with either a high-sensitivity stool-based test or a structural (visual) examination, depending on patient preference and test availability. As a part of the screening process, all positive results on noncolonoscopy screening tests should be followed up with timely colonoscopy. The recommendation to begin screening at age 45 years is a qualified recommendation. The recommendation for regular screening in adults aged 50 years and older is a strong recommendation. The ACS recommends (qualified recommendations) that: 1) average-risk adults in good health with a life expectancy of more than 10 years continue CRC screening through the age of 75 years; 2) clinicians individualize CRC screening decisions for individuals aged 76 through 85 years based on patient preferences, life expectancy, health status, and prior screening history; and 3) clinicians discourage individuals older than 85 years from continuing CRC screening. The options for CRC screening are: fecal immunochemical test annually; high-sensitivity, guaiac-based fecal occult blood test annually; multitarget stool DNA test every 3 years; colonoscopy every 10 years; computed tomography colonography every 5 years; and flexible sigmoidoscopy every 5 years. CA Cancer J Clin 2018;68:250-281. © 2018 American Cancer Society.

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“…Each method has shown some success [19–21]; and each has drawbacks, such as privacy limitations [22], cost, logistics or patient perception [23–25]. To our knowledge, evaluations of reminder letters have focused on one screening event and one health condition at a time; for example, mammography and breast cancer [26, 27], pap smear and cervical cancer [28, 29], or immunizations and influenza [29, 30].…”

Section: Introductionmentioning

confidence: 99%

Latina and Black/African American Women’s Perspectives on Cancer Screening and Cancer Screening Reminders

Brandzel

Chang

Tuzzio

et al. 2016

J. Racial and Ethnic Health Disparities

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Introduction Racial and ethnic disparities continue to exist in cancer screening rates, especially among U.S. Latina and Black/African American populations. We conducted six focus groups among 41 women from these communities in order to better understand their preferences about cancer screening reminders and the motivators and deterrents they face in obtaining recommended breast, cervical and colon cancer screening. Methods Using self-reported patient race/ethnicity from electronic medical records of a large, integrated health care system in Seattle, we recruited women ages 30–60 to participate in one of five two-hour focus groups. Using verbatim transcripts from these discussions, we conducted a qualitative analysis to identify common themes. Results The focus group participants were primarily strong endorsers and utilizers of recommended breast, cervical and colon cancer screening services. Insurance and belief in preventive care were the most common motivators that they cited in obtaining cancer screening. However, they still reported multiple barriers to getting recommended cancer screening for themselves and community members, including lack of time, conflicting information about screening intervals, distrust in the health care system, and a lack of understanding of the benefits of preventive care. Conclusions Efforts to improve understanding about the benefits of cancer screening, clarify cancer screening guideline recommendations, increase cultural competency among health care professionals, and expand the times and locations where cancer screening is available are all options that may improve cancer screening rates among Latinas and Black/African American women.

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Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers

Abstract: It is possible to achieve high rates of CRC screening over a 2-year period for vulnerable populations using outreach with FIT as a primary strategy.

Cited by 28 publications

References 9 publications

Third Annual Fecal Occult Blood Testing in Community Health Clinics

Third Annual Fecal Occult Blood Testing in Community Health Clinics

Colorectal cancer screening for average‐risk adults: 2018 guideline update from the American Cancer Society

Latina and Black/African American Women’s Perspectives on Cancer Screening and Cancer Screening Reminders

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