Effectiveness of Interventions to Increase Colorectal Cancer Screening Among American Indians and Alaska Natives

PEER REVIEWED

A flow diagram shows results of colorectal cancer screening participation among the 3 study groups. In the group 1 usual care group, consisting of 566 participants, 36 completed a FIT test. Among 361 group 2 participants who were mailed a FIT kit, 61 completed the FIT test during the study period, and among 361 group 3 participants who were mailed a FIT kit and also received follow-up outreach if the kit was not returned within 4 weeks, 41 participants completed FIT within 4 weeks of the mailing, another 12 completed FIT during the first 4-week period of CHR outreach, another 15 completed FIT during the second 4-week period of outreach, and no additional FITs were completed during the third outreach period.

Figure 1.
Participant selection, randomization, and outcomes in 3 study groups, intervention to increase colorectal cancer screening among American Indian and Alaska Native people (N = 1,288) served by 3 tribally operated health care clinics, April to November, 2014. Group 1, usual care, consisted of people who either did not visit the clinic, visited the clinic and did not receive a fecal immunochemical test (FIT) kit, or visited and received a FIT kit and instructions to complete at home. Group 2 participants received a FIT kit and completion instructions by mail. Group 3 participants received a mailed FIT kit and instructions, and nonrespondents received follow-up from a tribal community health representative after 4 weeks (by telephone), after 8 weeks (by home visit), and after 12 weeks by telephone. Abbreviations: CHR, community health representative; FIT, fecal immunochemical test.

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Figure 2.
Percentage of participants who completed the fecal immunochemical test, by intervention group. Brackets indicate confidence intervals.

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