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Erschienen in: Journal of General Internal Medicine 2/2020

14.11.2019 | Original Research

PreView: a Randomized Trial of a Multi-site Intervention in Diverse Primary Care to Increase Rates of Age-Appropriate Cancer Screening

verfasst von: Judith Walsh, MD, MPH, Michael Potter, MD, Rene Salazar, MD, Elizabeth Ozer, PhD, Ginny Gildengorin, PhD, Natasha Dass, BS, Lawrence Green, DrPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 2/2020

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Abstract

Background

Women aged 50–70 should receive breast, cervical (until age 65), and colorectal cancer (CRC) screening; men aged 50–70 should receive CRC screening and should discuss prostate cancer screening (PSA). PreView, an interactive, individually tailored Video Doctor Plus Provider Alert Intervention, adresses all cancers for which average risk 50–70-year-old individuals are due for screening or screening discussion.

Methods

We conducted a randomized controlled trial in 6 clinical sites. Participants were randomized to PreView or a video about healthy lifestyle. Intervention group participants completed PreView before their appointment and their clinicians received a “Provider Alert.” Primary outcomes were receipt of mammography, Pap tests (with or without HPV testing), CRC screening (FIT in last year or colonoscopy in last 10 years), and PSA screening discussion. Additional outcomes included breast, cervical, and CRC screening discussion.

Results

A total of 508 individuals participated, 257 in the control group and 251 in the intervention group. Screening rates were relatively high at baseline. Compared with baseline screening rates, there was no significant increase in mammography or Pap smear screening, and a nonsignificant increase (18% vs 12%) in CRC screening. Intervention participants reported a higher rate of PSA discussion than did control participants (58% vs 36%: P < 0.01). Similar increases were seen in discussions about mammography, cervical cancer, and CRC screening.

Conclusion

In clinics with relatively high overall screening rates at baseline, PreView did not result in significant increases in breast, cervical, or CRC screening. PreView led to an increase in PSA screening discussion. Clinician-patient discussion of all cancer screenings significantly increased, suggesting that interventions like PreView may be most useful when discussion of the pros and cons of screening is recommended and/or with patients reluctant to undergo screening. Future research should investigate PreView’s impact on those who are hesitant or reluctant to undergo screening.

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Metadaten
Titel
PreView: a Randomized Trial of a Multi-site Intervention in Diverse Primary Care to Increase Rates of Age-Appropriate Cancer Screening
verfasst von
Judith Walsh, MD, MPH
Michael Potter, MD
Rene Salazar, MD
Elizabeth Ozer, PhD
Ginny Gildengorin, PhD
Natasha Dass, BS
Lawrence Green, DrPH
Publikationsdatum
14.11.2019
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 2/2020
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-019-05438-0

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