Comparative Effectiveness of Multifaceted Outreach to Initiate Colorectal Cancer Screening in Community Health Centers: A Randomized Controlled Trial

ABSTRACT INTRODUCTION Colorectal cancer (CRC) screening rates are low among vulnerable populations. Fecal immunochemical tests (FITs) are one screening modality with few barriers. Studies have shown that outreach can improve CRC screening, but little is known about its effectiveness among individual...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM 2015-08, Vol.30 (8), p.1178-1184
Main Authors: Goldman, Shira N., Liss, David T., Brown, Tiffany, Lee, Ji Young, Buchanan, David R., Balsley, Kate, Cesan, Ana, Weil, Jordan, Garrity, Bridget H., Baker, David W.
Format: Article
Language:English
Subjects:
Aged
Colorectal cancer
Colorectal Neoplasms - prevention & control
Community health care
Community Health Centers
Comparative Effectiveness Research - methods
Delivery of Health Care - methods
Early Detection of Cancer - methods
Effectiveness
Female
Health care delivery
Health Status Disparities
Humans
Internal Medicine
Male
Mass Screening - methods
Medical screening
Medicine
Medicine & Public Health
Middle Aged
Occult Blood
Original Research
Vulnerable Populations
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Summary:ABSTRACT INTRODUCTION Colorectal cancer (CRC) screening rates are low among vulnerable populations. Fecal immunochemical tests (FITs) are one screening modality with few barriers. Studies have shown that outreach can improve CRC screening, but little is known about its effectiveness among individuals with no CRC screening history. We sought to determine whether outreach increases FIT uptake among patients with no CRC screening history compared to usual care. METHODS This study was a patient-level randomized controlled trial, including 420 patients who had never completed CRC screening and were eligible for FIT; 66 % were female, 62.1 % were Latino, and 70.7 % were uninsured. The main outcome measure was FIT completion within 6 months of the randomization date. We assessed FIT completion at different time points corresponding to receipt of outreach components. All analyses were re-run with 12-month data. RESULTS Patients who received outreach were more likely to complete FIT than those in usual care (36.7 % vs. 14.8 %; p  
ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-015-3234-5