Less than half of all positive fecal immunochemical testing (FIT)s are followed-up by colonoscopy, thus limiting the full potential of colorectal cancer (CRC) screening to reduce mortality. Given the need for coordination in order to achieve high rates of follow-up, multilevel approaches are needed. Such approaches could be particularly beneficial in communities and populations that experience cancer disparities and have fewer specialty providers, but most data focuses on large systems or urban areas. The academic-community health system collaboration is uniquely poised to address this research and service gap. The persistent poverty and health disparities in rural Southern Illinois set the stage for truly impactful research. The investigators' approach will serve as a model for multilevel interventions in rural settings, inform future work addressing other health disparities, and fill a gap in rigorous trials of CRC screening follow-up in rural areas.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
185,903
The intervention toolkit will include patient education materials and supportive materials for providers. Tracking systems and supports will be jointly developed with participating clinic and providers, in order to maximize their existing systems and develop processes that meet their needs and preferences, and training will be offered to help providers/teams efficiently use the tracking system and clinic resources. The study team will provide technical assistance and support through email, phone and zoom to support the clinic in their implementation process.
Washington University School of Medicine
St Louis, Missouri, United States
Number of referrals for colonoscopies after positive fecal immunochemical test
Time frame: Completion of follow-up (estimated to be 44 months)
Number of colonoscopy completions after positive fecal immunochemical test
-Within 60 days of referral
Time frame: Completion of follow-up (estimated to be 44 months)
Time to colonoscopy
Time frame: Completion of follow-up (estimated to be 44 months)
Proportion of participants who initiate a colonoscopy within 14 days of positive fecal immunochemical test
Time frame: Completion of follow-up (estimated to be 44 months)
Proportion of patients who complete a complete diagnostic evaluation within 60 days of positive fecal immunochemical test
Time frame: Completion of follow-up (estimated to be 44 months)
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