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.
Effect of a Mailed Brochure on Appointment Keeping for Screening Colonoscopy
|Program Title||Effect of a Mailed Brochure on Appointment Keeping for Screening Colonoscopy|
|Purpose||Designed to help increase colorectal cancer screening among adults. (2006)|
|Program Focus||Awareness building and Behavior Modification|
|Topic||Colorectal Cancer Screening|
|Age||Adults (40-65 years), Older Adults (65+ years)|
|Race/Ethnicity||Black, not of Hispanic or Latino origin, Hispanic or Latino, White, not of Hispanic or Latino origin|
|Funded by||American Cancer Society (Grant number(s): MRSG-06-081-01-CPPB)|
|User Reviews||(Be the first to write a review for this program)|
In an effort to reduce non-adherence to screening colonoscopy, the referring physician's office mails patients a one-page, two-sided brochure shortly after they receive referrals for a colonoscopy procedure. The brochure aims to educate patients about CRC and colonoscopy, address most common questions and concerns, and remind them to schedule a procedure. A secondary objective is to clearly inform patients ahead of time about bowel preparation and the risk of bleeding and perforation associated with the procedure. The introductory paragraph of the brochure is personalized to include the name of the patient's primary care physician. The brochure format makes use of color and large font and includes a diagram of the large intestines and colonoscopy. Written at an eighth-grade reading level, the brochure provides the following information:
- The similar lifetime risk for CRC for men and women at average risk
- The concept of cancer prevention and early detection
- The nature of polyps and early-stage cancer
- How screening may help prevent death
- The colonoscopy procedure
- Alternatives to colonoscopy
- The risk of colon perforation
- Preparation for a colonoscopy
Those implementing the intervention spend a negligible amount of time to prepare and send the brochure in the mail. Because the brochure is printed on one double-sided page and makes use of a large font size, a diagram, and text written at the eighth-grade reading level, time required for patients to read the brochure is expected to be minimal.
The investigators conducted a randomized, controlled trial to test the hypothesis that adherence to colonoscopy referrals is greater among patients who receive a mailed brochure with a description of a colonoscopy and a reminder to schedule a procedure than among patients who do not. Patients in the intervention condition received both usual care (face-to-face discussions with primary care physicians, referrals for colonoscopy, and written instructions to call to schedule a procedure) and the mailed brochure. Patients in the comparison condition received only usual care.
A total of 781 patients were included in the analyses, as follows: 38% men and 62% women; 77% were between the ages of 50 and 64; 23% were aged 65 or older; 57% were White, non-Latino; 9% were African American, non-Latino, and 4% were Latino; 31% self-identified as "other or unknown."
A hospital claims record was generated within an average of 4 weeks for each colonoscopy procedure completed. If no claims record was generated within a minimum of 4 months following referral, the procedure for that patient was coded as not completed.
- The overall adherence rate for colonoscopy screening was 11.7 percentage points greater in the intervention group than in the control group (70.7% vs. 59.0%; p=.001).
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