Promoting Veteran-Centered Colorectal Cancer Screening

Summary

Systematic efforts to improve colorectal cancer screening use in the VA Healthcare System have resulted in an increase in not only appropriate, but also inappropriate use of screening. The purpose of this study is to test a new, more patient-centered approach to colon cancer screening. In older individuals (ages 70 to 75) who are "due" for screening, the investigators will provide education on the benefits and harms of colon cancer screening. But instead of simply providing these patients with "average" information about these benefits, the investigators will give them information that takes into account their personal characteristics (e.g., age, gender), overall health, and screening history and therefore applies to them more personally. The investigators will also work with the health system to create time and space for patient and doctor to discuss whether screening is the right choice for each individual. This way, patients can make an informed choice about what is right for them, with the help of their doctor. In the future, the results of this study will help patients make more informed screening decisions, especially when the benefits of screening may be uncertain for them personally.

Conditions

• Colorectal Cancer

Interventions

BEHAVIORAL

Decision Aid

Printed booklet comprising educational information about benefits and harms of screening, individualized estimates of benefits and harms of screening, and values clarification exercise

BEHAVIORAL

Provider Education

Providers of patients in both arms of the study will be given an educational module about recent data on the benefits and harms of screening how these data fit in with existing population-centered guidelines.

BEHAVIORAL

Performance Measure Modification

The clinical reminder system will be modified so to facilitate documentation of informed decision making about CRC screening, including specific reasons for not screening. Additionally, providers who indicate a specific exception for not screening (using the modified clinical reminder) will be considered as satisfying the requirements and will not be penalized in terms of performance pay, and will be removed from feedback reports that encourage population screening.

BEHAVIORAL

Simple Informational Booklet

A simple informational booklet explaining colorectal cancer screening and current screening recommendations.

Sponsors & Collaborators

• University of Colorado, Denver

  collaborator OTHER

• Memorial Sloan Kettering Cancer Center

  collaborator OTHER

• Erasmus Medical Center

  collaborator OTHER

• VA Office of Research and Development

  lead FED

Principal Investigators

• Sameer D. Saini, MD MS · VA Ann Arbor Healthcare System, Ann Arbor, MI

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

70 Years

Max Age

75 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2015-11-20

Primary Completion

2018-08-08

Completion

2018-08-22

Countries

• United States

Study Locations