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Impact of Risk Talks on Patient Colorectal Screening [AHRQ]

Linda Larkey, PhD, MA

This project evaluates evaluating the effect of a physician- or staff-initiated discussion of personalized patient risk information for cancer on patient compliance for FOBT and sigmoidoscopy within six months of intervention/referral. This study is implemented in Arizona’s most populous county, Maricopa, within the indigent health care system reaching a high proportion of underserved, often minority, patients.  Patients are randomized by clinic to three arms of study: (a) Risk discussion presented by physician/clinician, (b) Risk discussion presented by staff such as nurse or educator in clinic, (c) no risk discussion (control). Over a year’s time, fifteen clinics will refer 150-200 patients each for screening.  In clinics randomized to either risk discussion treatment, the Harvard Cancer Risk Index (to be translated to local Spanish) will be completed by patients while waiting for visit to their doctor. Results of their scores will be discussed with emphasis on need for colorectal cancer prevention and screening.  In all groups, including control, physicians and staff will receive academic detailing concerning the importance of colorectal cancer screening, and will be given a systematic reminder to refer eligible patients.