Final Results of a 3-Year Literacy-Informed Intervention to Promote Annual Fecal Occult Blood Test Screening
| Autor: | Jill Hancock, Dachao Liu, Alfred Rademaker, Terry C. Davis, Geoffrey Lucas, Connie L. Arnold, Michael S. Wolf |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Health (social science) health care facilities manpower and services education Population Psychological intervention Health literacy Health Promotion Health Services Accessibility Article 03 medical and health sciences 0302 clinical medicine Interim medicine Humans 030212 general & internal medicine Early Detection of Cancer Aged Aged 80 and over education.field_of_study business.industry Fecal occult blood Public Health Environmental and Occupational Health Middle Aged Louisiana digestive system diseases Annual Screening Health Literacy Test (assessment) Health promotion Occult Blood 030220 oncology & carcinogenesis Family medicine Female business |
| Zdroj: | Journal of Community Health. 41:724-731 |
| ISSN: | 1573-3610 0094-5145 |
| Popis: | This three arm study was designed to make CRC screening with FOBTs more accessible, understandable and actionable for patients cared for in predominantly rural Federally Qualified Health Centers. Patients in an enhanced version of usual care received an annual CRC recommendation and FOBT kit; those in the education arm additionally received brief literacy and culturally appropriate education and those in the nurse arm received the education by a nurse manager who followed up by telephone. Baseline FOBT rates in this population were 3 %. We evaluated if FOBT rates could be sustained over 3 years. A three-arm, quasi-experimental evaluation was conducted among eight clinics in Louisiana. Screening efforts included: (1) enhanced usual care, (2) literacy-informed education of patients, and (3) education plus nurse support. Overall, 961 average-risk patients, ages 50-85, eligible for routine CRC screenings were recruited. The primary outcome was completing three annual FOBT tests. Of 961 patients enrolled, 381 (39.6 %) participants did not complete a single FOBT, 60.4 % completed at least one FOBT of which 318 (33.1 %) completed only one, 162 (16.9 %) completed two and 100 (10.4 %) completed three FOBTs over the 3-year period (the primary study outcome). The primary outcome, return of three FOBT kits over the 3-year period, was achieved by 4.7 % in enhanced care, 11.4 % in education and 13.6 % in the nurse arm (p = 0.005). Overall 3-year FOBT screening rates were not sustained with any of the three interventions, despite reports of promising interim results at years 1 and 2. New strategies for sustaining FOBT screening over several years must be developed. |
| Databáze: | OpenAIRE |
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