A randomized controlled trial of a tailored navigation and a standard intervention in colorectal cancer screening.
Publication/Presentation Date
1-1-2013
Abstract
BACKGROUND: This randomized, controlled trial assessed the impact of a tailored navigation intervention versus a standard mailed intervention on colorectal cancer screening adherence and screening decision stage (SDS).
METHODS: Primary care patients (n = 945) were surveyed and randomized to a Tailored Navigation Intervention (TNI) Group (n = 312), Standard Intervention (SI) Group (n = 316), or usual care CONTROL GROUP (n = 317). TNI Group participants were sent colonoscopy instructions and/or stool blood tests according to reported test preference, and received a navigation call. The SI Group was sent both colonoscopy instructions and stool blood tests. Multivariable analyses assessed intervention impact on adherence and change in SDS at 6 months.
RESULTS: The primary outcome, screening adherence (TNI Group: 38%, SI Group: 33%,
CONTROL GROUP: 12%), was higher for intervention recipients than controls (P = 0.001 and P = 0.001, respectively), but the two intervention groups did not differ significantly (P = 0.201). Positive SDS change (TNI Group: +45%, SI Group: +37%, and
CONTROL GROUP: +23%) was significantly greater among intervention recipients than controls (P = 0.001 and P = 0.001, respectively), and the intervention group difference approached significance (P = 0.053). Secondary analyses indicate that tailored navigation boosted preferred test use, and suggest that intervention impact on adherence and SDS was attenuated by limited access to screening options.
CONCLUSIONS: Both interventions had significant, positive effects on outcomes compared with usual care. TNI versus SI impact had a modest positive impact on adherence and a pronounced effect on SDS.
IMPACT: Mailed screening tests can boost adherence. Research is needed to determine how preference, access, and navigation affect screening outcomes.
Volume
22
Issue
1
First Page
109
Last Page
117
ISSN
1538-7755
Published In/Presented At
Myers, R. E., Bittner-Fagan, H., Daskalakis, C., Sifri, R., Vernon, S. W., Cocroft, J., Dicarlo, M., Katurakes, N., & Andrel, J. (2013). A randomized controlled trial of a tailored navigation and a standard intervention in colorectal cancer screening. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 22(1), 109–117. https://doi.org/10.1158/1055-9965.EPI-12-0701
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
23118143
Department(s)
Administration and Leadership
Document Type
Article