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Grant Details

Grant Number: 1R01CA166375-01A1 Interpret this number
Primary Investigator: Jones, Resa
Organization: Virginia Commonwealth University
Project Title: An Interactive Preventive Health Record to Increase Colorectal Cancer Screening
Fiscal Year: 2013


DESCRIPTION (provided by applicant): Nearly 40% of age-eligible U.S. adults are non-adherent to colorectal cancer screening (CRCS) recommendations and interventions to increase adherence can be less than optimally effective (fecal occult blood test kit mailings) or expensive (patient navigators). Few interventions take patient CRCS preference into accountant, to our knowledge; interventions have not systematically addressed test-specific patient-reported barriers. As the nation moves to the use of electronic health records, patient-centered health information technology systems (e.g., integrated personal health records), have great potential to improve quality of care by providing: centralized medical information, patient education and activation, enhanced patient and clinician communication, decision support, and reminder systems. Developing an effective, interactive tool that engages adults in making a CRCS decision is significant from a public health perspective as e-health has the ability to reach a large number of people at relatively little cost. We propose to combine screening and barriers information with preference elicitation strategies to create MyCRCS+, a novel, web-based, tailored decision aid tool embedded within personal health record systems to promote informed decisions and increase CRCS. This 5-year study involves 3 phases. Phase I consists of formative work to create the theory-based MyCRCS+ intervention, which will be integrated into an existing interactive preventive health record (IPHR). In short, MyCRCS+ will engage non-adherent patients (50-75 years) to assess their CRCS test preferences and corresponding test-specific barriers in "real time". Based on patient characteristics and data from the electronic medical record, tailored messages/video will appear in pop-up screens to reduce confusion and address their top 5 reported test-specific barriers while incorporating motivational strategies and an action plan. In Phase II we will conduct a 3-arm efficacy randomized trial (n=510; 170 people/arm) of two different versions of MyCRCS+ (one assessing and addressing Test Preferences only; the other assessing and addressing both Test Preferences and Test-specific Barriers) vs. standard IPHR-CRCS (usual care is web-based and provides basic information on CRCS and links to third-party web sites) with assessment at baseline, 3-months, and 12- months. In Phase III we will conduct a feasibility study of the most efficacious MyCRCS+ arm from Phase II in four primary care practices. We have effectively conducted research relevant to this application in various settings using similar designs, methods, and timelines to those proposed here.


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Enhanced care planning and clinical-community linkages versus usual care to address basic needs of patients with multiple chronic conditions: a clinician-level randomized controlled trial.
Authors: Krist A.H. , O'Loughlin K. , Woolf S.H. , Sabo R.T. , Hinesley J. , Kuzel A.J. , Rybarczyk B.D. , Kashiri P.L. , Brooks E.M. , Glasgow R.E. , et al. .
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Randomised trial to evaluate the effectiveness and impact of offering postvisit decision support and assistance in obtaining physician-recommended colorectal cancer screening: the e-assist: Colon Health study-a protocol study.
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Gaps in Well-Child Care Attendance Among Primary Care Clinics Serving Low-Income Families.
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Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications.
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MyPreventiveCare: implementation and dissemination of an interactive preventive health record in three practice-based research networks serving disadvantaged patients--a randomized cluster trial.
Authors: Krist A.H. , Aycock R.A. , Etz R.S. , Devoe J.E. , Sabo R.T. , Williams R. , Stein K.L. , Iwamoto G. , Puro J. , Deshazo J. , et al. .
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