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Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers

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Abstract

Purpose

We previously found that a multifaceted outreach intervention achieved 82 % annual adherence to colorectal cancer (CRC) screening with fecal occult blood testing (FOBT). This study assessed adherence to FOBT after a second outreach.

Methods

We followed 225 patients in community health centers in Chicago, Illinois, who were randomized to the intervention group. Our primary analysis focused on 124 patients who completed FOBT during the first outreach and were due again for annual FOBT; 90 % were Latino, 87 % preferred to speak Spanish, and 77 % were uninsured. Second outreach consisted of (1) a mailed reminder letter, a free fecal immunochemical test (FIT) with postage-paid return envelope, (2) automated phone and text messages, (3) automated reminders 2 weeks later if the FIT was not returned, and (4) a telephone call after 3 months. Our main outcome was completion of FIT within 6 months of the due date. We also analyzed the proportion of the original 225 patients who were fully screened for CRC over the 2-year study period.

Results

A total of 88.7 % of patients completed a FIT within 6 months of their second outreach. Over the 2 years since the first outreach, 71.6 % of the 225 patients assigned to the intervention group were fully up to date on CRC screening, another 11.1 % had been screened suboptimally, and 17.3 % were inadequately screened or not screened.

Conclusions

It is possible to achieve high rates of CRC screening over a 2-year period for vulnerable populations using outreach with FIT as a primary strategy.

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Acknowledgments

This research project was funded by the Agency of Healthcare Research and Quality (P01 HS021141). The funding agency had no involvement in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication. We would like to thank the staff and patients of Erie Family Health Center for their support of this study.

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Authors and Affiliations

  1. Division of General Internal Medicine and Geriatrics, Department of Medicine, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL, 60611, USA

    David W. Baker, Tiffany Brown, Shira N. Goldman, David T. Liss & Ji Young Lee

  2. Center for Advancing Equity in Clinical Preventive Services, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    David W. Baker, Tiffany Brown, Shira N. Goldman, David T. Liss & Ji Young Lee

  3. Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA

    David W. Baker

  4. Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

    David W. Baker

  5. Erie Family Health Center, Chicago, IL, USA

    Stephanie Kollar, Kate Balsley & David R. Buchanan

Authors
  1. David W. Baker
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  2. Tiffany Brown
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  3. Shira N. Goldman
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  4. David T. Liss
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  5. Stephanie Kollar
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  6. Kate Balsley
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  7. Ji Young Lee
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  8. David R. Buchanan
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Corresponding author

Correspondence to David W. Baker.

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Baker, D.W., Brown, T., Goldman, S.N. et al. Two-year follow-up of the effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers. Cancer Causes Control 26, 1685–1690 (2015). https://doi.org/10.1007/s10552-015-0650-0

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  • DOI: https://doi.org/10.1007/s10552-015-0650-0

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