Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2013 Jan;22(1):109-17.
doi: 10.1158/1055-9965.EPI-12-0701. Epub 2012 Nov 1.

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

Ronald E Myers  1 , Heather Bittner-Fagan, Constantine Daskalakis, Randa Sifri, Sally W Vernon, James Cocroft, Melissa Dicarlo, Nora Katurakes, Jocelyn Andrel
Affiliations
Randomized Controlled Trial

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

Ronald E Myers et al. Cancer Epidemiol Biomarkers Prev. 2013 Jan.

Abstract

Background: 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).

Methods: 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.

Results: The primary outcome, screening adherence (TNI Group: 38%, SI Group: 33%,

Control group: 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

Control group: +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.

Conclusions: 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.

Impact: Mailed screening tests can boost adherence. Research is needed to determine how preference, access, and navigation affect screening outcomes.

PubMed Disclaimer

Conflict of interest statement

None of the co-authors has a conflict of interest to report for this manuscript.

Figures

Figure 1
Figure 1. Intervention trial schema
SI: Standard Intervention. TNI: Tailored Navigation Intervention. (*) Numbers prior to randomization include some patients more than once (patients who were not contacted or not enrolled initially, but who were recontacted in subsequent study waves).
See this image and copyright information in PMC

References

    1. American Cancer Society. Cancer Facts and Figures 2012. Atlanta, GA: American Cancer Society; 2012. [cited 2012 August 23]. Available from http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/docume....
    1. U.S. Preventive Services Task Force. Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Oct, 2008. AHRQ Publication 08-05124-EF-3. - PubMed
    1. Klabunde CN, Lanier D, Nadel MR, McLeod C, Yuan G, Vernon SW. Colorectal cancer screening by primary care physicians: Recommendations and practices, 2006–2007. American Journal of Preventative Medicine. 2009;37(1):8–16. - PMC - PubMed
    1. Center for Disease Control and Prevention. Colorectal Cancer Screening Rates. Atlanta, GA: CDC; 2011. [cited 2012 August 23]. Available from http://www.cdc.gov/cancer/colorectal/statistics/screening_rates.htm.
    1. U.S. Department of Health and Human Services. Healthy People 2020 – Topics and Objectives: Cancer. Washington, DC: 2010. [cited 2012 August 23]. Available from: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?t....

Publication types