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Rationale and design of Mi-CARE: The mile square colorectal cancer screening, awareness and referral and education project.

Abstract：

:Although colorectal cancer (CRC) is largely preventable through identification of pre-cancerous polyps through various screening modalities, morbidity and mortality rates remain a challenge, especially in African-American, Latino, low-income and uninsured/underinsured patients. Barriers to screening include cost, access to health care facilities, lack of recommendation to screen, and psychosocial factors such as embarrassment, fear of the test, anxiety about testing preparation and fear of a cancer diagnosis. Various intervention approaches to improve CRC screening rates have been developed. However, comparative effectiveness research (CER) to investigate the relative performance of different approaches has been understudied, especially across different real-life practice settings. Assessment of differential efficacy across diverse vulnerable populations is also lacking. The current paper describes the rationale and design for the Mile Square Colorectal Cancer Screening, Awareness and Referral and Education Project (Mi-CARE), which aims to increase CRC screening rates in 3 clinics of a large Federally Qualified Health Center (FQHC) by reducing prominent barriers to screening for low-income, minority and underserved patients. Patients attending these clinics will receive one of three interventions to increase screening uptake: lay patient navigator (LPN)-based navigation, provider level navigation, or mailed birthday CRC screening reminders. The design of our program allows for comparison of the effectiveness of the tailored interventions across sites and patient populations. Data from Mi-CARE may help to inform the dissemination of tailored interventions across FQHCs to reduce health disparities in CRC.

journal_name

Contemp Clin Trials

journal_title

Contemporary clinical trials

authors

Buscemi J,Miguel YS,Tussing-Humphreys L,Watts EA,Fitzgibbon ML,Watson K,Winn RA,Matthews KL,Molina Y

doi

10.1016/j.cct.2016.11.009

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

75-79

eissn

1551-7144

issn

1559-2030

pii

S1551-7144(16)30189-6

journal_volume

pub_type

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Rationale and design of Mi-CARE: The mile square colorectal cancer screening, awareness and referral and education project.