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Influence of a Brief Intervention on CRC Screening

ABSTRACT: Qualitative data were collected from 5 General Practionners (GPs) focus groups, 24 patient interviews and 35 recorded consultations from 9 GPs to explore colorectal cancer (CRC) screening in France The qualitative data indicated that improvement was needed in patient-centered communication. Educational material was developed based on these triangulated data with two different scenarios to improve communication with patients: one for a compliant patient, another for a non compliant patient The hypothesis is that a brief intervention on GPs can improve the patients’ participation rate to colorectal screening Method : cluster randomized control trial (cluster unit : GPs practices) With a brief intervention on a randomized population of GPs in the district of Val d’Oise Inclusion criteria: GPs with a practice in the district of Val d’Oise and active in the colorectal mass screening

DISEASE(S): Colorectal Cancer,Colorectal Neoplasms

PROVIDER: 2156987 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: The intervention is a novel, shared model of care between cancer services and primary health care using an interactive e-care plan called Inca and telehealth using telemedicine technology. It is being implemented at 2 public and 2 private cancer services in the South Eastern Sydney Local Health District. The e-care plan program is integrated with GP clinical information systems and includes care plan templates for colorectal and breast cancer follow-up care developed from the published literature and agreed guidelines for survivorship care plans. The e-care plan program provides a collaborative space for clinicians and patients to agree on the goals, tasks, responsibilities and the scheduling and monitoring of care. Other functionalities include the sharing of pathology results, measures (e.g. BMI, blood pressure), a health summary and a progress notes section for the specialist, GP or patient to add a note. Documents can be uploaded and downloaded. It provides the basis for non-urgent communication between specialists, GPs, patients and other care team members (e.g. allied health providers) who can be added to the care team and given access. Inca automatically emails notifications to the care team when changes are made to the e-care plan or when upcoming tasks and appointments are due. Patients will be emailed reminders for appointments or tasks that are upcoming from Inca. The e-care plan is not integrated with cancer service clinical systems. Cancer services and patients access the e-care plan through an online portal. This is a non-randomised quasi-experimental trial. Patients at the St George Cancer Centre and the Prince of Wales Private will be allocated to the intervention. Patients at the Prince of Wales Nelune Comprehensive Cancer Centre and the S Primary outcome(s): The quality of communication and information shared to support patient follow-up will be assessed by comparing participant satisfaction and experiences with communication and information sharing within and between groups. Methods Questionnaires will be administered at baseline, 9 months plus 18 months post commencement of follow-up care for delayed intervention group: The Short Form Patient Satisfaction Questionnaire (access, interpersonal manner and communication subscales) (Marshall GN, 1994) and The Survivors Unmet Needs Survey (access and continuity of care subscale) (Campbell HS, 2011) GP Questionnaire - Satisfaction with communication (Jefford M, 2008). Specialist and care coordinator questionnaire (satisfaction with communication and information shared) Qualitative interviews with a sample of intervention participants (10 patients, 5-7 GPs and 3-5 specialists) by phone with a researcher at 9 months and 18 months post commencement of follow-up care for the delayed intervention group [9 months post commencement of follow-up care plus 18 months for the delayed intervention group];Access to and continuity of follow-up care will be assessed by comparing participant satisfaction and experiences with follow-up care within and between groups. Methods: Questionnaires will be administered at baseline, 9 months plus 18 months post commencement of follow-up care for delayed intervention group: Short Form Patient Satisfaction Questionnaire (Marshall GN, 1994) and The Survivors Unmet Needs Survey (access and continuity of care subscale) (Campbell HS, 2011) Qualitative interviews with a sample of intervention participants (10 patients, 5-7 GPs and 3-5 specialists) by phone with a researcher at 9 months and 18 months post commencement of follow-up care for the delayed intervention group [9 months post commencement of follow-up care plus 18 months for the delayed intervention group] Study Design: Purpose: Prevention; Allocation: Non-randomised trial

Project description:Colorectal cancer is the 2nd leading cause of cancer mortality in France. However this cancer is preventable in the majority of cases by early detection of adenomas. In France, there is organized colorectal cancer screening, which relies on general practitioners (GPs). Tests delivered by GPs are performed in 89% of cases. However, GPs do not systematically offer the test, for time management and communication reasons. Patients expect their GPs to offer the test and to focus on their expectations. A previous study conducted on GPs showed that training in communication and motivational interviewing increases the number of tests performed by 12.2%. In order to facilitate the promotion of screening, the investigators would like to develop a training programme for GPs focusing on the application of Motivational Interviewing (MI) techniques to the promotion of colorectal cancer screening. Motivational Interviewing is a directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. This study is a multicenter trial in general medicine. In this randomized trial the 902 subjects will be included prospectively by the general practitioners (GP) participating in the study. As a first step, general practitioners who have never participated in Motivational Interviewing training will be recruited and split into 2 groups by randomization, an intervention group and a control group. The interventional group will then undergo a 3 times 2-day training in Motivational Interviewing. In a second step, the patients will be included by those GP and a self-questionnaire will be send at the inclusion and after 6, 12 and 24 months. The evaluation of the number of tests performed and the analyse of the Health Belief Model (HBM) self-questionnaire will be carried out. At 24 months, there will be an evaluation of the denial motivation questionnaire for patients who have not participated in organized colorectal cancer screening.

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Influence of a Brief Intervention on CRC Screening

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