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National Institutes of Health: National Cancer Institute: Division of Cancer Control and Population Sciences
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

Systems Of Support To Increase Colorectal Cancer Screening And Follow-up Rates (sos): Design, Challenges, And Baseline Characteristics Of Trial Participants
Authors: Green B.B. , Wang C.Y. , Horner K. , Catz S. , Meenan R.T. , Vernon S.W. , Carrell D. , Chubak J. , Ko C. , Laing S. , et al. .
Source: Contemporary Clinical Trials, 2010 Nov; 31(6), p. 589-603.
PMID: 20674774
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The Hypertension Team: The Role Of The Pharmacist, Nurse, And Teamwork In Hypertension Therapy
Authors: Carter B.L. , Bosworth H.B. , Green B.B. .
Source: Journal Of Clinical Hypertension (greenwich, Conn.), 2012 Jan; 14(1), p. 51-65.
PMID: 22235824
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Nonparticipation In A Population-based Trial To Increase Colorectal Cancer Screening
Authors: Green B.B. , Bogart A. , Chubak J. , Vernon S.W. , Morales L.S. , Meenan R.T. , Laing S.S. , Fuller S. , Ko C. , Wang C.Y. .
Source: American Journal Of Preventive Medicine, 2012 Apr; 42(4), p. 390-7.
PMID: 22424252
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An Automated Intervention With Stepped Increases In Support To Increase Uptake Of Colorectal Cancer Screening: A Randomized Trial
Authors: Green B.B. , Wang C.Y. , Anderson M.L. , Chubak J. , Meenan R.T. , Vernon S.W. , Fuller S. .
Source: Annals Of Internal Medicine, 2013-03-05 00:00:00.0; 158(5 Pt 1), p. 301-11.
PMID: 23460053
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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 S.S. , Green B.B. .
Source: Preventive Medicine, 2013 Nov; 57(5), p. 671-8.
PMID: 24029556
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Psychological Distress After A Positive Fecal Occult Blood Test Result Among Members Of An Integrated Healthcare Delivery System
Authors: Laing S.S. , Bogart A. , Chubak J. , Fuller S. , Green B.B. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2014 Jan; 23(1), p. 154-9.
PMID: 24220914
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Challenges And Possible Solutions To Colorectal Cancer Screening For The Underserved
Authors: Gupta S. , Sussman D.A. , Doubeni C.A. , Anderson D.S. , Day L. , Deshpande A.R. , Elmunzer B.J. , Laiyemo A.O. , Mendez J. , Somsouk M. , et al. .
Source: Journal Of The National Cancer Institute, 2014 Apr; 106(4), p. dju032.
PMID: 24681602
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Time To Screening In The Systems Of Support To Increase Colorectal Cancer Screening Trial
Authors: Wang C.Y. , de Dieu Tapsoba J. , Anderson M.L. , Vernon S.W. , Chubak J. , Fuller S. , Green B.B. .
Source: Cancer Epidemiology, Biomarkers & Prevention : A Publication Of The American Association For Cancer Research, Cosponsored By The American Society Of Preventive Oncology, 2014 Aug; 23(8), p. 1683-8.
PMID: 24891548
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"benefits" To Increase Colorectal Cancer Screening In Priority Populations
Authors: Green B.B. , Coronado G.D. .
Source: Jama Internal Medicine, 2014 Aug; 174(8), p. 1242-3.
PMID: 24934255
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Longitudinal Predictors Of Colorectal Cancer Screening Among Participants In A Randomized Controlled Trial
Authors: Murphy C.C. , Vernon S.W. , Haddock N.M. , Anderson M.L. , Chubak J. , Green B.B. .
Source: Preventive Medicine, 2014 Sep; 66, p. 123-30.
PMID: 24937648
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Results Of Nurse Navigator Follow-up After Positive Colorectal Cancer Screening Test: A Randomized Trial
Authors: Green B.B. , Anderson M.L. , Wang C.Y. , Vernon S.W. , Chubak J. , Meenan R.T. , Fuller S. .
Source: Journal Of The American Board Of Family Medicine : Jabfm, 2014 Nov-Dec; 27(6), p. 789-95.
PMID: 25381076
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An Economic Evaluation Of Colorectal Cancer Screening In Primary Care Practice
Authors: Meenan R.T. , Anderson M.L. , Chubak J. , Vernon S.W. , Fuller S. , Wang C.Y. , Green B.B. .
Source: American Journal Of Preventive Medicine, 2015 Jun; 48(6), p. 714-21.
PMID: 25998922
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