Video brochures in a mailed fecal immunochemical test outreach program provide cancer screening information in a user-friendly format for rural Appalachian community members

• Published in: The Journal of rural health 2024-01, Vol.40 (1), p.96-103
• Main Authors: Katz, Mira L, Shoben, Abigail B, Newell, Sabrina, Hall, Christina, Emerson, Brent, Gray, 2nd, Darrell M, Chakraborty, Subhankar, Reiter, Paul L
• Format: Article
• Language: English
• Subjects: Adult; Adults; Brochures; Cancer; Cancer screening; Colonoscopy; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - diagnosis; Early Detection of Cancer; Feces; Gloves; Health facilities; Humans; Information; Mass Screening; Medical screening; Middle Aged; Occult Blood; Outreach programs; Outreach services; Patients; Pilot Projects; Rural areas; Rural health care; Tests
• ISSN: 0890-765X; 1748-0361; 1748-0361
• DOI: 10.1111/jrh.12772

Colorectal cancer (CRC) screening is recommended for average-risk adults, yet many adults are not up-to-date with screening. One recommended CRC screening approach is the annual completion of a fecal immunochemical test (FIT). However, usually, fewer than half of mailed FIT tests are returned. To address barriers to FIT return, a video brochure was developed providing targeted CRC screening information and step-by-step FIT instructions as a component in a mailed FIT program. This pilot study occurred in 2021-2022 and partnered with a federally qualified health center in Appalachian Ohio to send a FIT to patients who were 50-64 years old, of average risk, and not up-to-date on CRC screening. Patients were randomly assigned to 1 of 3 groups that differed on materials sent with the FIT: usual care (manufacturer's instructions), a video brochure (video instructions, disposable gloves, disposable stool collection device), or an audio brochure (audio instructions, disposable gloves, disposable stool collection device). Overall, 16 of 94 patients (17%) returned the FIT, and return was higher among those sent the video brochure (28%) compared to the other 2 groups (OR: 3.1; 95% CI: 1.02, 9.2; P = .046). Two patients had positive tests and were referred for colonoscopy. Patients sent the video brochure reported the content was important, relevant, and made them think about completing the FIT. Using a video brochure to provide understandable information in a mailed FIT kit is a promising strategy to improve CRC screening outreach programs in rural regions.