The purpose of this research study is to evaluate the efficacy of a digital navigation tool, called the eNav to improve colorectal cancer screening uptake among patients treated at federally qualified health centers (FQHC)s. The digital navigation tool includes a website and text messaging support. The website includes information, motivational support, decisional support and cues to action (e.g., ability to request a CRC screening test). The eNav tool also includes text-messaging based navigation (e.g., reminders, instructions to complete the screening test).
This is a multi-site randomized clinical trial to evaluate the efficacy of the eNav Toolkit. A total of 400 participants will be from four FQHC clinics within the Institute for Family Health FQHC network. Participants will be randomly assigned to one of two groups: 1. eNav group (N=200) or 2. usual care group (N=200) Participants will consent and complete a baseline questionnaire (demographics, medical information) 1-4 weeks before their primary care appointment. Those in the intervention group will receive a link to the eNav website. The digital navigation tool includes a website and text-messaging support. The website includes information, motivational support, decisional support and cues to action (e.g., ability to request a CRC screening test). The eNav tool also includes text-messaging based navigation (e.g., reminders, instructions to complete the screening test). The control group will receive standard clinical care. Then 3-6 weeks after that primary care appointment, the research team will reach out to participants to complete a follow-up questionnaire. The follow up questionnaire will assess constructs guided by the health belief model (e.g., self-efficacy, benefits/barriers for CRC screening). The impact of the eNav Toolkit on CRC screening completion at 6 months will be evaluated by checking their medical records. If a patient does not have a CRC screening recorded in their medical record, the research team will call the patient to inquire whether they have completed the CRC screening.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
400
The eNav toolkit is a digital navigation toolkit that includes a website and text messaging support. The website includes information, motivational support, decisional support and cues to action (e.g., ability to request a CRC screening test). The eNav tool also includes text-messaging based navigation (e.g., reminders, instructions to complete the screening test).
Standard of care procedures for selecting their CRC screening test.
Icahn School of Medicine at Mount Sinai
New York, New York, United States
Colorectal Cancer (CRC) Screening completion
CRC, Yes/No Medical chart review will determine whether the CRC screening was complete. If a patient does not have a CRC screening result recorded in their medical record, the research team will call the patient to inquire whether they have completed the CRC screening.
Time frame: End of study, at 6 months
Number of participants who complete screening tests with adequate quality
The number of participants who complete the screening test (i.e., colonoscopy, FIT or FIT-DNA) with adequate quality. Test quality will be coded as "inadequate" if the test needs to be repeated or cannot be resulted due to inadequate quality (e.g., poor bowel prep, inadequate stool sample).
Time frame: End of study, at 6 months
Number of participants who complete the screening test with inadequate preparation
The number of participants who complete the screening test and the preparation is inadequate (e.g., poor bowel prep quality, inadequate stool sample collection).
Time frame: End of study, at 6 months
Adherence to follow up recommendations
Record if the study participant is following the colorectal cancer screening recommendations after the CRC test has been completed. Measured as: Yes = participant completed the recommended follow up No = participant did NOT complete the recommended follow up In process = the recommended follow up does not fall within the 6-month time frame Missing = data not available in the medical chart
Time frame: End of study, at 6 months
The Colorectal Cancer Screening Beliefs Instrument Score
The assessments specifically measure the following Health Belief Model scales: * Perceived Benefits of Stool-based Tests: min 3 - max 15 * Perceived Benefits of Colonoscopy: min 3 - max 15 * Perceived Susceptibility: min 2 - max 10 * Perceived Barriers of Stool-Based Tests: min 7 - max 35 * Perceived Barriers of Colonoscopy: min 9 - max 45 * Perceived Self-Efficacy of Stool-based Tests: min 8 - max 40 * Perceived Self-Efficacy of Colonoscopy: min 12 - max 60 * Perceive Severity: min 3 - max 15 Higher scores indicate greater benefit/barriers levels of the scale (e.g., higher scores = more barriers, more benefits, higher perceived susceptibility of CRC, higher levels of self-efficacy), there is no summed score.
Time frame: Approximately 3-4 weeks after primary care appointment
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