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Translation of Colorectal Cancer Screening Guidelines: A System Intervention


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Not Enrolling
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Colorectal Cancer

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Trial Information

Translation of Colorectal Cancer Screening Guidelines: A System Intervention


Objectives: 1.To implement an electronic CRC screening event notification system
intervention to improve complete evaluation of patients with a positive FOBT at four of
eight VAMCs randomized to this intervention vs usual care.

2.To conduct a qualitative evaluation to identify implementation barriers and facilitators,
and to guide modifications of the CRC-ENS. 3.To conduct an outcome evaluation to determine
the effectiveness of the intervention to:

a. increase the proportion of patients with a positive FOBT receiving CDE. b. reduce the
time-lag between notification of a positive FOBT result and scheduling of a follow-up
endoscopic procedure. 4. To improve patient compliance with follow-up recommendations
through a combined scheduling/motivational telephone contact. 5. To assess VA primary care
providers' knowledge, beliefs, attitudes and practices regarding FOBT screening and
follow-up.

Methods: The CRC-ENS intervention employs a relatively simple alteration to the current
electronic mechanism for notifying the primary care provider (PCP) of when a positive FOBT
is recorded. With the CRC-ENS, this notification will be forwarded to the gastroenterology
(GI) clinic as well as the PCP. This notification at the GI clinic will set off a cascade
of events that would normally only be triggered by a consult request from the PCP. In this
translation study, eight participating VHA sites will be randomly assigned to either the
CRC-ENS intervention or comparison group. The proposed project will take two years to
complete. During the first project year, the participating sites will be recruited and
randomized. Pre-intervention change of awareness strategies will be initiated at all
intervention sites. The CRC-ENS intervention will be implemented in the second project
year, and formative evaluation (including two sets of focus groups) will be carried out
throughout the intervention period. Post-intervention data collection, outcome evaluation
and dissemination of results will be carried out in months 18-24.


Inclusion Criteria:



- VA Medical Centers with either CORI (Clinical Outcomes Research Initiative) or
electronic notes/descriptions documenting GI endoscopic procedures

Exclusion Criteria:

- VA Medical Centers without electronic GI procedure documentation

Type of Study:

Interventional

Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention

Outcome Measure:

Change in rates and timeliness of FOBT positive follow-up.

Outcome Time Frame:

6 months

Safety Issue:

No

Principal Investigator

Linda L. Humphrey, MD MPH

Investigator Role:

Principal Investigator

Investigator Affiliation:

Portland

Authority:

United States: Federal Government

Study ID:

CRT 02-059

NCT ID:

NCT00122187

Start Date:

August 2005

Completion Date:

May 2008

Related Keywords:

  • Colorectal Cancer
  • cancer
  • colonoscopy
  • mass screening
  • colorectal cancer
  • colorectal carcinoma
  • reminder systems
  • rectal cancers
  • colorectal tumor
  • guidelines
  • CRC secondary prevention
  • colorectal neoplasms
  • colonic neoplasms
  • colonic diseases
  • hemoccult testing
  • Colorectal Neoplasms

Name

Location

Durham VA Medical Center HSR&D COEDurham, North Carolina  27705
Carl T. Hayden VA Medical CenterPhoenix, Arizona  85012
VA Eastern Colorado Health Care System, DenverDenver, Colorado  80220
VA Medical & Regional Office Center, White RiverWhite River Junction, Vermont  05009-0001
Southern Arizona VA Health Care SystemTucson, Arizona  85723
Overton Brooks VA Medical CenterShreveport, Louisiana  71101-4295
MinneapolisMinneapolis, Minnesota  55417
PortlandPortland, Oregon  97239-2964
VA Medical Center, NashvilleNashville, Tennessee  37212-2637