Connie L Arnold1, Alfred Rademaker2, Michael S Wolf3, Dachao Liu2, Jill Hancock4, Terry C Davis4. 1. Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA. carnol@lsuhsc.edu. 2. Department of Preventive Medicine and the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA. 3. Medicine and Learning Sciences, Associate Chair, Department of Medicine, Associate Division Chief - Research, Department of General Internal Medicine and Geriatrics Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. 4. Department of Medicine and Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA.
Abstract
OBJECTIVES: Our objective was to determine the effectiveness of 3 approaches to encourage completion of fecal occult blood testing (FOBT) in the third year of the intervention. METHODS:Between 2008 and 2011, a quasi-experimental intervention was conducted in 8 predominantly rural Federally Qualified Health Centers. Clinics were randomly assigned to enhanced care (screening recommendation and FOBT kit mailed annually), education (patients additionally received a health literacy appropriate pamphlet and simplified FOBT instructions), or nurse support (same as education but with nurse follow-up). Participants included 206 patients with negative FOBTs in years 1 and 2; ages 50-85, 80% female, 70% African American, and 52% had limited health literacy. The main outcome measure was completion of a third annual FOBT. RESULTS:Third-year FOBT rates were 48% overall, 34.2% enhanced care, 59.6% education, and 47.4% nurse support (p = .21), even after adjustment for sex, marital status, and health literacy. CONCLUSION: All mailed interventions were similarly effective in sustaining rates of FOBT screening. Post hoc analyses of the results analyzed by health literacy skills found that patients with both limited and adequate health literacy skills were more likely to complete FOBTs when mailed simplified instructions.
RCT Entities:
OBJECTIVES: Our objective was to determine the effectiveness of 3 approaches to encourage completion of fecal occult blood testing (FOBT) in the third year of the intervention. METHODS: Between 2008 and 2011, a quasi-experimental intervention was conducted in 8 predominantly rural Federally Qualified Health Centers. Clinics were randomly assigned to enhanced care (screening recommendation and FOBT kit mailed annually), education (patients additionally received a health literacy appropriate pamphlet and simplified FOBT instructions), or nurse support (same as education but with nurse follow-up). Participants included 206 patients with negative FOBTs in years 1 and 2; ages 50-85, 80% female, 70% African American, and 52% had limited health literacy. The main outcome measure was completion of a third annual FOBT. RESULTS: Third-year FOBT rates were 48% overall, 34.2% enhanced care, 59.6% education, and 47.4% nurse support (p = .21), even after adjustment for sex, marital status, and health literacy. CONCLUSION: All mailed interventions were similarly effective in sustaining rates of FOBT screening. Post hoc analyses of the results analyzed by health literacy skills found that patients with both limited and adequate health literacy skills were more likely to complete FOBTs when mailed simplified instructions.
Authors: Joshua J Fenton; Joann G Elmore; Diana S M Buist; Robert J Reid; Daniel J Tancredi; Laura-Mae Baldwin Journal: Ann Fam Med Date: 2010 Sep-Oct Impact factor: 5.166
Authors: Ann G Zauber; Iris Lansdorp-Vogelaar; Amy B Knudsen; Janneke Wilschut; Marjolein van Ballegooijen; Karen M Kuntz Journal: Ann Intern Med Date: 2008-10-06 Impact factor: 25.391
Authors: Amy Duncan; Deborah Turnbull; Carlene Wilson; Joanne M Osborne; Stephen R Cole; Ingrid Flight; Graeme P Young Journal: BMC Public Health Date: 2014-03-07 Impact factor: 3.295
Authors: Jeffrey K Lee; Veronica Reis; Shanglei Liu; Lorraine Conn; Erik J Groessl; Theodore G Ganiats; Samuel B Ho Journal: J Gen Intern Med Date: 2009-09-23 Impact factor: 5.128
Authors: Connie L Arnold; Alfred W Rademaker; James D Morris; Laurie Anne Ferguson; Gary Wiltz; Terry C Davis Journal: Cancer Date: 2019-07-29 Impact factor: 6.860
Authors: Michael K Dougherty; Alison T Brenner; Seth D Crockett; Shivani Gupta; Stephanie B Wheeler; Manny Coker-Schwimmer; Laura Cubillos; Teri Malo; Daniel S Reuland Journal: JAMA Intern Med Date: 2018-12-01 Impact factor: 21.873
Authors: Terry C Davis; James D Morris; Elise H Reed; Laura M Curtis; Michael S Wolf; Adrienne B Davis; Connie L Arnold Journal: Contemp Clin Trials Date: 2021-12-11 Impact factor: 2.261
Authors: Siddhartha Roy; Sabrina Dickey; Hsiao-Lan Wang; Alexandria Washington; Randy Polo; Clement K Gwede; John S Luque Journal: J Community Health Date: 2021-02
Authors: John S Luque; Matthew Vargas; Kristin Wallace; Olayemi O Matthew; Rima Tawk; Askal A Ali; Gebre-Egziabher Kiros; Cynthia M Harris; Clement K Gwede Journal: J Cancer Educ Date: 2021-04-26 Impact factor: 1.771
Authors: Terry C Davis; Connie L Arnold; Glenn Mills; Glenn J Lesser; W Mark Brown; Richard Schulz; Kathryn E Weaver; Pamala A Pawloski Journal: Int J Environ Res Public Health Date: 2021-10-21 Impact factor: 4.614