Low-Literacy Physician-Patient Intervention Promoting Colorectal Cancer Screening

This study will test the separate and combined effect of two of these interventions: 1) a provider communication skills training using a continuous quality improvement (CQI) framework, and 2) a brief, multimedia Patient Education Program (PEP) that incorporates plain language, graphic design, and audio voice-over to overcome literacy limitations. Our provider intervention has demonstrated efficacy to significantly improve CRC screening recommendation rates. Our multimedia program has also been field tested among patients with limited literacy and was able to improve patient knowledge and intention to receive screening.

We will implement both provider-only and combined provider-patient strategies within a federally qualified health center network to determine the most effective and efficient approach to promote CRC screening in these settings. Results from the study, supplemented by cost analyses and the process evaluation will directly inform translational strategies for cancer prevention within difficult community-based healthcare settings.

Inclusion criteria

• Patients aged 50-75 years of age (in month 1 of the study)
• Patients have had two or more visits to the clinic during the past two years
• ACCESS Community Health Network patients
• University of Illinois Hospital & Health Sciences System patients
• Patients ages 50 - 75 as of the start of the intervention study
• English or Spanish-Speaking

Exclusion criteria

• Patients <50 or > 75 years of age
• Patients who have had fewer than two or more visits to the clinic during the past two years
• Personal history of CRC or colorectal polyps, or of inflammatory bowel disease and a family history with a first-degree relative with CRC or colorectal polyps.
• Unable to speak English or Spanish
• Compliant with CRC screening (FOBT or FIT within the past year; flexible sigmoidoscopy within past 5 years; colonoscopy within past 10 years)