The Implementation Guide is a resource for implementing this program. It provides important information about the staffing and functions necessary for administering this program in the user's setting. Additionally, the steps needed to carry out the research-tested program, relevant program materials, and information for evaluating the program are included. The Implementation Guide can be viewed and downloaded in the Products page.
Mailed Reminder to Increase Completion of Fecal Occult Blood Testing (FOBT) for Veterans
|Program Title||Mailed Reminder to Increase Completion of Fecal Occult Blood Testing (FOBT) for Veterans|
|Purpose||Designed to promote colorectal cancer (CRC) screening among adults. (2009)|
|Program Focus||Awareness building and Behavior Modification|
|Topic||Colorectal Cancer Screening|
|Age||Adults (40-65 years), Older Adults (65+ years)|
|Race/Ethnicity||Alaskan Native, American Indian, Asian, Black, not of Hispanic or Latino origin, Hispanic or Latino, Pacific Islander, White, not of Hispanic or Latino origin|
|Funded by||NCRR (Grant number(s): T32RR023254), NIDDK (Grant number(s): DK080506), DoVA (Grant number(s): IIR07-101)|
|User Reviews||(Be the first to write a review for this program)|
CRC screening can detect colorectal cancer at an early stage to maximize the potential for treatment to be effective. Further, the detection and removal of polyps can prevent colorectal cancer from developing. The U.S. Preventive Services Task Force recommends regular screening beginning at age 50 and continuing until age 75 using high-sensitivity fecal occult blood testing (FOBT), sigmoidoscopy, or colonoscopy. Despite these recommendations, only 65% of adults are up to date with colorectal cancer screening. Interventions designed to promote colorectal cancer screening are needed among military veterans.
-- 3 minutes per patient for the clinician to review the chart and assemble and send the educational reminder
-- Mailed Reminder Flyer
For costs associated with this program, please contact the developers, Samuel B. Ho or Gelareh (Rose) Ganji. (See products page on the RTIPs website for developer contact information.)
During visits to the clinics, patients were instructed by the physician to pick up an FOBT kit for screening at the laboratory, complete it, and return it using the postage-paid return envelope. Patients who picked up the cards were subsequently randomized to the intervention group (n=389) or the usual care group (n=386) with the use of a random-number generator. The average age of participants was 63.1 years; 96.3% were male, 72.8% were White, 11.7% were African American, and 56.6% were unmarried. The groups were well matched in terms of demographic and clinical characteristics at baseline.
Ten days after the visit, patients in the intervention group received mailed reminders. The primary outcome was percentage of patients returning the FOBT card within 6 months of receiving it. Screening rates were assessed through the review of administrative databases and an electronic medical record database by a clinical research assistant who was blinded to the patients study group assignment. To examine factors associated with FOBT completion, other data extracted from patient records included demographic characteristics, prior FOBT completion, number of scheduled and kept VA appointments over the past year, history of several diseases and mental disorders, current or recent use of illicit drugs, and current use of tobacco or alcohol.
- At 6-month follow-up, FOBT screening rates were higher in the intervention group than the usual care group (64.6% vs. 48.4%; p<.001).
- Having a history of completing FOBTs was a significant predictor of FOBT completion, with higher compliance rates found among patients who had completed a greater number of previous FOBTs (compared with no history of FOBT completion, completion of one FOBT, OR=1.87; completion of two FOBTs, OR=3.89; completion of three FOBTs, OR=4.05). Current or recent illicit drug use was a significant predictor of FOBT non-completion (OR=0.26).
Lee JK, Reis V, Liu S, Conn L, Groessl EJ, Ganiats TG, Ho SB. (2009). Improving fecal occult blood testing compliance using a mailed educational reminder. Journal of General Internal Medicine, 24 (11), 1192-1197.
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