Increasing referral rate for screening colonoscopy through patient education and activation at a primary care clinic in New York City.

Colorectal cancer could be prevented through regular screening. Individuals age 50 and older are recommended to get screened via colonoscopy. Because physician referral is a major predictor of colonoscopy completion, two low-cost, evidence-based interventions were tested to increase referrals by activating patients to self-advocate. This study compared the impact of a pre-visit educational handout that prompts patients to discuss colonoscopy with their physician with the handout plus brief counseling through exit interviews and chart reviews. The main outcome was physician referral. Medical charts were reviewed for eligibility: 130 control patients (Arm 1), 45 patients who received the educational handout and health counseling (Arm 2), and 50 patients who received only the handout (Arm 3). Colonoscopy referral rates increased from 24.6% in Arm 1 to 44.4% and 52.0% in Arms 2 and 3, respectively (p=0.001). The proportion of exit interview participants who discussed colonoscopy with their doctor increased from 68.8% in Arm 1 to 76.5% and 88.9% in Arms 2 and 3, respectively. Results indicate that both interventions are effective at increasing colonoscopy referrals. Results suggest that an educational handout alone is sufficient in prompting patient-initiated discussions about colonoscopy.

Sriphanlop P ，Hennelly MO ，Sperling D ，Villagra C ，Jandorf L ... -  《-》

The Effectiveness of a Physician-Only and Physician-Patient Intervention on Colorectal Cancer Screening Discussions Between Providers and African American and Latino Patients.

Dolan NC ，Ramirez-Zohfeld V ，Rademaker AW ，Ferreira MR ，Galanter WL ，Radosta J ，Eder MM ，Cameron KA ... -  《-》

Improving colorectal cancer screening among the medically underserved: a pilot study within a federally qualified health center.

Khankari K ，Eder M ，Osborn CY ，Makoul G ，Clayman M ，Skripkauskas S ，Diamond-Shapiro L ，Makundan D ，Wolf MS ... -  《-》

Racial/Ethnic Minorities Ineligible for Direct Access Colonoscopy (DAC): Identifying Patients Who Fall Through the Cracks.

Miller SJ ，Sly JR ，Itzkowitz SH ，Jandorf L ... -  《-》

Patient-Reported Needs Following a Referral for Colorectal Cancer Screening.

Patient-physician communication about colorectal cancer screening can affect screening use, but discussions often lack information that patients need for informed decision making and seldom address personal preferences or barriers. To address this gap, a series of patient focus groups was conducted to guide the development of an online, interactive decision support program. This article presents findings on patient information needs and barriers to colorectal cancer screening after receiving a screening recommendation from a physician, and their perspectives on using electronic patient portals as platforms for health-related decision support. Primary care patients with recent colonoscopy or stool testing orders were identified via the centralized data repository of a large Midwestern health system. Seven gender-stratified focus groups (N=45 participants) were convened between April and July 2016. Sessions were audio recorded, transcribed, coded, and analyzed for commonly expressed themes beginning in August 2016. Findings reveal a consistent need for simple and clear information on colorectal cancer screening. Participants desired step-by-step explanations of the colonoscopy procedure and information about bowel preparation options/alternatives. The desired level of additional information varied: some patients wanted to know about and act on test options, whereas others preferred following their physician-recommended testing path. Fears and concerns were prevalent, particularly about colonoscopy, and patients reported challenges getting these concerns and their informational needs addressed. Finally, they expressed consistent support for using the patient portal to gather additional information from their physician. Patient portals may offer an opportunity to build sustainable programs for decision support and assistance that are integrated with clinic workflows and processes.

Dyer KE ，Shires DA ，Flocke SA ，Hawley ST ，Jones RM ，Resnicow K ，Shin Y ，Lafata JE ... -  《-》