Facilitators and Barriers to Cancer Screening: Stakeholder Perspectives on Implementation
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|ClinicalTrials.gov Identifier: NCT04683744|
Recruitment Status : Recruiting
First Posted : December 24, 2020
Last Update Posted : April 8, 2021
The rate of screening for colorectal cancer (CRC) in the U.S. remains low (under 65%), meaning that thousands of people die of colorectal cancer unnecessarily. Colorectal cancer screening tests range from more invasive and very sensitive for polyps and cancer (colonoscopy) to less invasive and less sensitive (e.g., fecal immunochemical testing (FIT)). Screening rates go up when patients consider all these tests, not just colonoscopy. Informing patients about their options for CRC screening could produce higher quality decisions, improve the match between patient preferences and tests performed, and increase uptake of CRC screening. Decision aids (DAs) are a promising tool for accomplishing this goal. Also, precision CRC prevention - providing information about an individual's specific risk for CRC - has great promise to increase uptake and improve decision making.
Unfortunately, the COVID-19 pandemic is causing severe challenges to providing CRC screening and other prevention services. Health systems are trying to adapt, but these efforts have only begun and are poorly understood. Moreover, patient perceptions of disease risk and risk from COVID-19 are unknown.
|Condition or disease||Intervention/treatment|
|Colorectal Cancer Screening||Other: Semi-structured interviews-Patients Other: Semi-structured interviews-Health system|
The study team will engage with the leadership, staff, and providers in the study team's partner healthcare systems, to identify facilitators and barriers to implementing patient decision aids and provider notifications as well as cancer risk assessment tools, for colorectal cancer screening, and for other evidence-based cancer screening during the COVID pandemic and, potentially, after the conclusion of the pandemic.
At the conclusion of the study, the investigators will have extensive information regarding how best to provide decision aids through an electronic health record (EHR) portal, with or without personalized information, and to deliver provider notifications, which can guide broader implementation.
The study will involve interviews with staff and providers at the study team's partner healthcare systems to identify facilitators and barriers to implementing decision aids and provider notifications for colorectal cancer screening.
Also, the investigators will interview patients to identify perceptions of prevention during the COVID-19 pandemic including risk perception and barriers to screening, perceptions of risk from both the pandemic and disease, and patient cancer screening and risk prevention behaviors engaged in or postponed during the pandemic and patient rationales for their decisions. This part of the study will suggest potentially promising approaches for providing prevention and disease management during the COVID-19 pandemic.
|Study Type :||Observational|
|Estimated Enrollment :||100 participants|
|Official Title:||Facilitators and Barriers to Cancer Screening: Stakeholder Perspectives on Implementation|
|Actual Study Start Date :||January 11, 2021|
|Estimated Primary Completion Date :||July 2023|
|Estimated Study Completion Date :||July 2023|
Healthcare system leadership, providers, and staff
Leadership, providers, and staff at the study team's affiliated health systems.
Other: Semi-structured interviews-Health system
The interview guide will consist of questions to elicit thoughts from health system leadership, providers, and staff about implementing decision aids, provider notifications, and cancer risk assessments in their health center or healthcare system. The questions may be specific to colorectal cancer screening or more generally about other cancer screenings. The investigators may also ask questions about cancer screening initiatives their health center or healthcare system engaged in during the COVID-19 pandemic.
Patients receiving primary care at the study team's affiliated health systems
Patients who had a least one primary care visit during the past 24 months at the study team's affiliated health care systems.
Other: Semi-structured interviews-Patients
The interview guide will consist of questions to elicit the patients thoughts about getting preventive healthcare during the COVID-19 pandemic, including perception of risk, barriers to getting healthcare, and information needed for decision making.
- Identify facilitators and barriers to implementing decision aids, provider notifications, and personal risk calculation using an electronic health record to promote colorectal cancer screening. [ Time Frame: 2 years ]Semi-structured interviews with health system leadership, providers and staff conducted every 3-4 months
- Identify the challenges and facilitators of effective cancer screening and prevention in primary care during the COVID-19 pandemic among leadership, providers, and staff. [ Time Frame: 9 months ]Semi-structured interviews with health system leadership, providers, and staff
- Identify patient knowledge, attitudes, and beliefs that influence decisions to engage in cancer screening and prevention during the COVID-19 pandemic, and barriers to uptake [ Time Frame: 1 day ]Semi-structured interviews with primary care patients
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04683744
|United States, Indiana|
|Indianapolis, Indiana, United States, 462020|
|Contact: Karen K Schmidt, MSN 317-278-4049 firstname.lastname@example.org|