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Ann Intern Med. 2004 Nov 2;141(9):683-92.

Patient education for colon cancer screening: a randomized trial of a video mailed before a physical examination.

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  • 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.

Abstract

BACKGROUND:

Colorectal cancer screening is underused, and primary care clinicians are challenged to provide patient education within the constraints of busy practices.

OBJECTIVE:

To test the effect of an educational video, mailed to patients' homes before a physical examination, on performance of colorectal cancer screening, particularly sigmoidoscopy.

DESIGN:

Randomized, controlled trial.

SETTING:

5 primary care practices in central Massachusetts.

PARTICIPANTS:

938 patients age 50 to 74 years who were scheduled for an upcoming physical examination, had no personal history of colorectal cancer, and were eligible for lower-endoscopy screening according to current guidelines.

INTERVENTION:

Participants were randomly assigned to receive usual care (n = 488) or a video about colorectal cancer, the importance of early detection, and screening options (n = 450).

MEASUREMENTS:

Baseline and 6-month follow-up telephone assessments were conducted. A dependent variable classified screening since baseline as 1) sigmoidoscopy with or without other tests, 2) another test or test combination, or 3) no tests.

RESULTS:

Overall screening rates were the same in the intervention and control groups (55%). In regression modeling, intervention participants were nonsignificantly more likely to complete sigmoidoscopy alone or in combination with another test (odds ratio, 1.22 [95% CI, 0.88 to 1.70]). Intervention dose (viewing at least half of the video) was significantly related to receiving sigmoidoscopy with or without another test (odds ratio, 2.81 [CI, 1.85 to 4.26]). Recruitment records showed that at least 23% of people coming for periodic health assessments were currently screened by a lower-endoscopy procedure and therefore were not eligible.

LIMITATIONS:

The primary care sample studied consisted primarily of middle-class white persons who had high screening rates at baseline. The results may not be generalizable to other populations. The trial was conducted during a period of increased health insurance coverage for lower-endoscopy procedures and public media attention to colon cancer screening.

CONCLUSIONS:

A mailed video had no effect on the overall rate of colorectal cancer screening and only modestly improved sigmoidoscopy screening rates among patients in primary care practices.

PMID:
15520425
[PubMed - indexed for MEDLINE]
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