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Storytelling to Promote Colorectal Screening in Primary Care Clinics [NCI]

Linda Larkey, PhD, MA

Much of the research on risk communication has addressed the lay public’s ability to interpret and act on numeric risk information. In contrast, community programs often use lay educators who share personal stories to convey information about risk. We will undertake a randomized, controlled trial to examine effects of Storytelling (ST) versus a Usual Care (UC), numeric form of communication on patient compliance for colorectal cancer screening (CRCS) referrals. Patients in low-income, primarily Medicare/Medicaid funded clinics due for CRCS will be randomized to one of two groups to receive a two-step intervention, one step prior to the clinical encounter, and one step after.  Storytelling will be compared with usual care in both step. We will randomize 450 patients referred for screening (225 each arm). We have preliminary data demonstrating feasibility of gaining ~90% compliance from providers to refer patients for screening using a reminder card. Secondary Hypothesis: Patients exposed to ST will be more likely to express intent to screen than those exposed to UC. Identification and engagement with the story and perceptions of threat, fear and stress will be assessed as mediators. Findings will potentially inform effective primary care practice interventions for CRCS.