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Grant Details

Grant Number: 2R01CA121125-06 Interpret this number
Primary Investigator: Green, Beverly
Organization: Group Health Cooperative
Project Title: Systems of Support (SOS) to Increase Colon Cancer Screening and Follow-Up
Fiscal Year: 2013
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Abstract

DESCRIPTION (provided by applicant): The lifetime risk of colorectal cancer is over 5% in the United States where, despite recent declines in incidence and mortality, colorectal cancer remains the second highest cause of cancer death. Better treatments have improved survival rates, but morbidity and mortality could be more rapidly and cost-effectively reduced by achieving higher uptake and long-term adherence to colorectal cancer screening. The Systems of Support to Decrease Colorectal Cancer (SOS) study successfully advanced colorectal screening. SOS was a 4-arm randomized controlled trial that leveraged electronic health record data and automated systems to implement stepwise increases in screening support. Patients due for screening (n=4675) were randomized to (1) Usual Care, (2) Automated care (automated mailings and fecal occult blood tests), (3) automated plus assisted care from medical assistants (phone reminders and sending orders to physicians to sign), or (4) automated + assisted + navigated care from registered nurses (follow-up until test completion). Interventions were repeated in year 2. Compared to usual care, intervention patients were more likely to be current for colorectal cancer screening in both study years, with increases by intervention intensity: Usual Care 26.5%, Automated 50.7%, Assisted 57.7%, and Navigated 64.4% (P<.001). We propose to improve and continue SOS interventions up to 10 years and measure their effects on long-term adherence and outcomes. We will: 1. Identify factors related to low or non-adherence to screening despite receiving continued interventions and apply these findings to a stepped intervention to increase uptake and long-term adherence of screening. 2. Assess the effectiveness of the SOS interventions on long-term screening adherence up to 10 years. 3. Describe the impact of SOS interventions on colorectal cancer-related costs and clinical outcomes.

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Publications

Longitudinal predictors of colorectal cancer screening among participants in a randomized controlled trial.
Authors: Murphy CC, Vernon SW, Haddock NM, Anderson ML, Chubak J, Green BB
Source: Prev Med, 2014 Sep;66, p. 123-30.
EPub date: 2014 Jun 15.
PMID: 24937648
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"BeneFITs" to increase colorectal cancer screening in priority populations.
Authors: Green BB, Coronado GD
Source: JAMA Intern Med, 2014 Aug;174(8), p. 1242-3.
PMID: 24934255
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Time to screening in the systems of support to increase colorectal cancer screening trial.
Authors: Wang CY, de Dieu Tapsoba J, Anderson ML, Vernon SW, Chubak J, Fuller S, Green BB
Source: Cancer Epidemiol Biomarkers Prev, 2014 Aug;23(8), p. 1683-8.
EPub date: 2014 Jun 2.
PMID: 24891548
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Psychological distress after a positive fecal occult blood test result among members of an integrated healthcare delivery system.
Authors: Laing SS, Bogart A, Chubak J, Fuller S, Green BB
Source: Cancer Epidemiol Biomarkers Prev, 2014 Jan;23(1), p. 154-9.
EPub date: 2013 Nov 12.
PMID: 24220914
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Uptake and positive predictive value of fecal occult blood tests: A randomized controlled trial.
Authors: Chubak J, Bogart A, Fuller S, Laing SS, Green BB
Source: Prev Med, 2013 Nov;57(5), p. 671-8.
EPub date: 2013 Sep 9.
PMID: 24029556
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An automated intervention with stepped increases in support to increase uptake of colorectal cancer screening: a randomized trial.
Authors: Green BB, Wang CY, Anderson ML, Chubak J, Meenan RT, Vernon SW, Fuller S
Source: Ann Intern Med, 2013 Mar 5;158(5 Pt 1), p. 301-11.
PMID: 23460053
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Nonparticipation in a population-based trial to increase colorectal cancer screening.
Authors: Green BB, Bogart A, Chubak J, Vernon SW, Morales LS, Meenan RT, Laing SS, Fuller S, Ko C, Wang CY
Source: Am J Prev Med, 2012 Apr;42(4), p. 390-7.
PMID: 22424252
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The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy.
Authors: Carter BL, Bosworth HB, Green BB
Source: J Clin Hypertens (Greenwich), 2012 Jan;14(1), p. 51-65.
EPub date: 2011 Nov 28.
PMID: 22235824
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Systems of support to increase colorectal cancer screening and follow-up rates (SOS): design, challenges, and baseline characteristics of trial participants.
Authors: Green BB, Wang CY, Horner K, Catz S, Meenan RT, Vernon SW, Carrell D, Chubak J, Ko C, Laing S, Bogart A
Source: Contemp Clin Trials, 2010 Nov;31(6), p. 589-603.
EPub date: 2010 Jul 30.
PMID: 20674774
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