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


ABSTRACT: 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).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.The primary outcome, screening adherence (TNI Group: 38%, SI Group: 33%,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+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.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.Mailed screening tests can boost adherence. Research is needed to determine how preference, access, and navigation affect screening outcomes.

SUBMITTER: Myers RE 

PROVIDER: S-EPMC5537598 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

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

Myers Ronald E RE   Bittner-Fagan Heather H   Daskalakis Constantine C   Sifri Randa R   Vernon Sally W SW   Cocroft James J   Dicarlo Melissa M   Katurakes Nora N   Andrel Jocelyn J  

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 20121101 1


<h4>Background</h4>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).<h4>Methods</h4>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 instructi  ...[more]

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