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Grant Details

Grant Number: 5R01CA069653-03 Interpret this number
Primary Investigator: Zapka, Jane
Organization: Univ Of Massachusetts Med Sch Worcester
Project Title: Increasing Colorectal Cancer Screening
Fiscal Year: 2000


Adenocarcinoma of the colon and rectum is a major cause of death from cancer in the United States and most authorities now recommend that persons over age 50 be offered screening for colorectal cancer (CRC) because of recent evidence that screening is effective in reducing CRC mortality. However, rates of patient adherence with screening sigmoidoscopy recommendations are low and little research has been done to explain this limited compliance or to identify methods for increasing patient participation. We propose a randomized trial to measure the efficacy of an educational video in increasing compliance with flexible sigmoidoscopy screening (primary trial outcome). Subjects are established primary care patients who have a scheduled non-urgent appointment with their primary care physician. A stratified sample (gender/age) of 600 people will be randomized to the intervention or comparison condition. Intervention subjects will be mailed a video cassette with accompanying written brochure prior to their appointment. It will emphasize patient-centered education and will utilize role models to discuss barriers and enhance motivation. During their visit, patients in both study conditions will receive a standardized recommendation on CRC and printed material from the physician. The primary trial outcome is completion of the recommended sigmoidoscopy. Secondary outcomes include initial acceptance of the recommendation, and selected knowledge, attitude and belief measures which are hypothesized to be influenced by the video. Telephone interviews will be conducted at baseline (To), directly after the appointment (T1), and within four months after the primary care visit during which period a sigmoidoscopy could have been completed (T2). The content and format of the video will be informed by focus groups and a random digit dial survey of a representative sample of Massachusetts residents over age 50. The survey will identify knowledge levels, beliefs, and attitudes about CRC and sigmoidoscopy; document rates of CRC screening; and identify factors independently related to sigmoidoscopy screening intention and behavior, including personal predisposing factors and enabling and reinforcing health system factors and other potential mediating factors.


Comprehensive cancer screening in a primary care population: Gender differences in the impact of ambulatory care system factors.
Authors: Lemon S.C. , Zapka J.G. , Puleo E. .
Source: The Journal of ambulatory care management, 2005 Jan-Mar; 28(1), p. 86-97.
PMID: 15682966
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Patient education for colon cancer screening: a randomized trial of a video mailed before a physical examination.
Authors: Zapka J.G. , Lemon S.C. , Puleo E. , Estabrook B. , Luckmann R. , Erban S. .
Source: Annals of internal medicine, 2004-11-02; 141(9), p. 683-92.
PMID: 15520425
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Screening for colorectal cancer on the front line.
Authors: Lemon S.C. , Zapka J.G. , Estabrook B. , Erban S. , Luckmann R. .
Source: The American journal of gastroenterology, 2003 Apr; 98(4), p. 915-23.
PMID: 12738477
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Healthcare system factors and colorectal cancer screening.
Authors: Zapka J.G. , Puleo E. , Vickers-Lahti M. , Luckmann R. .
Source: American journal of preventive medicine, 2002 Jul; 23(1), p. 28-35.
PMID: 12093420
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Colorectal cancer screening participation: comparisons with mammography and prostate-specific antigen screening.
Authors: Lemon S. , Zapka J. , Puleo E. , Luckmann R. , Chasan-Taber L. .
Source: American journal of public health, 2001 Aug; 91(8), p. 1264-72.
PMID: 11499116
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Risk and reluctance: understanding impediments to colorectal cancer screening.
Authors: Weitzman E.R. , Zapka J. , Estabrook B. , Goins K.V. .
Source: Preventive medicine, 2001 Jun; 32(6), p. 502-13.
PMID: 11394954
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Colorectal cancer screening in Massachusetts: measuring compliance with current guidelines.
Authors: Erban S. , Zapka J. , Puleo E. , Vickers-Lahti M. .
Source: Effective clinical practice : ECP, 2001 Jan-Feb; 4(1), p. 10-7.
PMID: 11234181
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