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Prev Med. 2014 Jan;58:70-4. doi: 10.1016/j.ypmed.2013.10.018. Epub 2013 Nov 8.

Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky.

Author information

1
University of Kentucky, Department of Internal Medicine, 800 Rose Street, Room CC444, Lexington, KY 40536-0093, USA. Electronic address: Mbdign2@email.uky.edu.
2
Department of Biostatistics, University of Kentucky, USA; Markey Cancer Center, University of Kentucky, USA.
3
Markey Cancer Center, University of Kentucky, USA.
4
College of Public Health, University of Kentucky, USA.
5
Department of Behavioral Science, University of Kentucky, USA.
6
Department of Family & Community Medicine, University of Kentucky, USA.
7
College of Social Work, University of Kentucky, USA.

Abstract

OBJECTIVE:

This report describes findings from a randomized controlled trial of an intervention to increase colorectal cancer (CRC) screening in primary care practices in Appalachian Kentucky.

METHODS:

Sixty-six primary care practices were randomized to early or delayed intervention groups. The intervention was provided at practices using academic detailing, a method of education where providers receive information on a specific topic through personal contact. Data were collected in cross-sectional surveys of medical records at baseline and six months post-intervention.

RESULTS:

A total of 3844 medical records were reviewed at baseline and 3751 at the six-month follow-up. At baselines, colonoscopy was recommended more frequently (43.4%) than any other screening modality, followed by fecal occult blood testing (18.0%), flexible sigmoidoscopy (0.4%), and double-contrast barium enema (0.3%). Rates of documented screening results were higher for all practices at the six-month follow-up for colonoscopy (31.8% vs 29.6%) and fecal occult blood testing (12.2% vs 11.2%). For early intervention practices that recommended screening, colonoscopy rates increased by 15.7% at six months compared to an increase of 2.4% in the delayed intervention practices (p=.01).

CONCLUSIONS:

Using academic detailing to reach rural primary care providers with a CRC screening intervention was associated with an increase in colonoscopy.

KEYWORDS:

Appalachia; Colorectal cancer screening; Primary care; Randomized controlled trial

PMID:
24212061
PMCID:
PMC3925970
DOI:
10.1016/j.ypmed.2013.10.018
[Indexed for MEDLINE]
Free PMC Article

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