ArticleClinical and translational gastroenterology2018
A Multi-Level Fit-Based Quality Improvement Initiative to Improve Colorectal Cancer Screening in a Managed Care Population.
Article in Clinical and translational gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Selection of patients for large mailed fecal immunochemical test colorectal cancer screening outreach programs: A systematic review.Journal of medical screening · 2021Pooled it
- Effect of Patient Portal Messaging Before Mailing Fecal Immunochemical Test Kit on Colorectal Cancer Screening Rates: A Randomized Clinical Trial.JAMA network open · 2022Trial
- System-Wide Implementation of Colorectal Cancer Screening in a Value-Based Care Setting.Journal of general internal medicine · 2026Observational
- Comparing the effectiveness of implementation strategies to improve liver and colon cancer screening for Veterans: protocol for a large cluster-randomized implementation study.Implementation science : IS · 2025Article
- The use of individual and multilevel data in the development of a risk prediction model to predict patients' likelihood of completing colorectal cancer screening.Preventive medicine reports · 2023Article
- Improving Colorectal Cancer Screening at an Employer-Sponsored Health Plan During the COVID-19 Pandemic.Journal of general internal medicine · 2022Article
- Undertaking general practice quality improvement to improve cancer screening - a thematic analysis of provider experiences.BMC family practice · 2021Article
- Noninvasive Colorectal Cancer Screening Tests Help Close Screening Gaps During Coronavirus Disease 2019 Pandemic.Gastroenterology · 2021Article
- What Multilevel Interventions Do We Need to Increase the Colorectal Cancer Screening Rate to 80%?Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2021Review
- Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature.Health services insights · 2021Article
- Development of a multivariable prediction model to identify patients unlikely to complete a colonoscopy following an abnormal FIT test in community clinics.BMC health services research · 2020Article
- Making FIT Count: Maximizing Appropriate Use of the Fecal Immunochemical Test for Colorectal Cancer Screening Programs.Journal of general internal medicine · 2020Article
- Abnormal Colorectal Cancer Test Follow-Up: A Quality Improvement Initiative at a Federally Qualified Health Center.Journal of primary care & community healthArticle
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionColorectal cancer (CRC) is a common but largely preventable disease with suboptimal screening rates despite national guidelines to screen individuals age 50-75. Single-component interventions aimed to improve screening uptake only modestly improve rates; data suggest that multi-modal approaches may be more effective.
methodsWe designed, implemented, and evaluated the impact of a multi-modal intervention on CRC screening uptake among unscreened patients in a large managed care population. Patient-level components included a mailed letter with education about screening options and pre-colonoscopy telephone counseling. For providers, we facilitated communication of screening test results and work-flow for abnormal results. System-level modifications included establishment of a patient navigator, expedited work-up for abnormal results, and stream-lined colonoscopy scheduling. We measured the rate of screening uptake overall, screening uptake by modality, change in the proportion of the population screened, and positive fecal immunochemical test (FIT) follow-up rates in the 1-year study period.
resultsThere were 5093 patients in the intervention cohort. Of these, 33.2% participated in FIT or colonoscopy screening within 1 year of the mailing. A total of 1078 (21.2%) participants completed a FIT and 611 (12.0%) completed a screening colonoscopy. The screening rate in the managed care population increased from 65.1 to 76.6%. Fifty-nine patients (5.5%) had a positive FIT, of which 30 (50.8%) completed a diagnostic colonoscopy.
conclusionMulti-modal interventions can result in substantial improvement in CRC screening uptake in large and diverse managed care populations. TRANSLATIONAL IMPACT: Health systems should shift their focus from single-level to multi-level interventions when addressing barriers to CRC screening.
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