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Cancer Epidemiol Biomarkers Prev. 2013 Jan;22(1):109-17. doi: 10.1158/1055-9965.EPI-12-0701. Epub 2012 Nov 1.

A randomized controlled trial of a tailored navigation and a standard intervention in colorectal cancer screening.

Author information

1
Department of Medical Oncology, Thomas Jefferson University, 1025 Walnut Street, Suite 1014, Philadelphia, PA 19107, USA. ronald.myers@jefferson.edu

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.

PMID:
23118143
PMCID:
PMC5537598
DOI:
10.1158/1055-9965.EPI-12-0701
[Indexed for MEDLINE]
Free PMC Article
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