Skip to main content
An official website of the United States government
Grant Details

Grant Number: 5R01CA196243-05 Interpret this number
Primary Investigator: Paskett, Electra
Organization: Ohio State University
Project Title: Comparative Effectiveness of Interventions to Improve Screening Among Rural Women
Fiscal Year: 2019


 DESCRIPTION (provided by applicant): In 2014 approximately 310,030 women in the United States (U.S.) will be diagnosed with breast cancer (BC), cervical cancer (CC), or colorectal cancer (CRC), and 68,060 women will die from these cancers. These three cancers account for 39% of the cancer burden and 25% of the cancer mortality among women in the U.S. Although effective screening tests are widely available for all three cancers, many women do not adhere to screening guidelines. Furthermore, the burden of these cancers is higher among some population groups and regions. Thirty-two rural counties in northwest Ohio and northeast Indiana share similar socioeconomically underserved populations of predominately (96.2%) white women who have elevated BC, CRC, and CC mortality rates, and lower screening rates with mammography, Pap tests, and fecal occult blood testing or colonoscopy. No known intervention has addressed improving screening rates for these three main female cancers simultaneously, even though multiple health behavior change research is emerging as a new model to change the way in which interventions can be packaged. The proposed project uses an overall theoretical framework to understand health disparities which includes individual, social and community level variables, and a conceptual model for the intervention which uses a multiple behavior theoretical approach, all of which have demonstrated efficacy in improving adherence to single screening test behaviors, as well as other preventive health behaviors. The goal of this proposal is to test the comparative effectiveness of a tailored interactive computer program delivered via DVD (TIDVD) vs. a TIDVD + telephone-based patient navigation (PN) intervention (TNI) vs. Usual Care (UC) to increase guideline-based screening rates for BC, CC, and CRC among women age 50 to 74 living in these rural counties of Ohio and Indiana. Specific aims are to: 1) compare the effectiveness of a tailored and interactive DVD (TIDVD) vs. TIDVD + telephone-based PN intervention (TNI) vs. UC, to increase guideline-based cancer screening rates at 12 months post randomization for BC, CC, and CRC among 1058 women age 50 to 74 living in rural northwest Ohio and northeast Indiana; and 2) compare the cost effectiveness of the TIDVD and the TIDVD + TNI intervention vs. UC, for adherence to each screening outcome or combination of screening tests. As an Exploratory Aim, we will identify associations between theoretical variables (community, social, and individual) and screening outcomes, including interactions with the interventions. If found to be cost effective, either or both interventions hae the potential to be immediately disseminated to increase BC, CC, and CRC screening rates and ultimately reduce cancer disparities for underserved rural women.


Receipt, uptake, and satisfaction with tailored DVD and patient navigation interventions to promote cancer screening among rural women.
Authors: Rawl S.M. , Baltic R. , Monahan P.O. , Stump T.E. , Hyer M. , Ennis A.C. , Walunis J. , Renick K. , Hinshaw K. , Paskett E.D. , et al. .
Source: Translational behavioral medicine, 2023-12-15; 13(12), p. 879-890.
PMID: 37708322
Related Citations

Comparative Effectiveness of 2 Interventions to Increase Breast, Cervical, and Colorectal Cancer Screening Among Women in the Rural US: A Randomized Clinical Trial.
Authors: Champion V.L. , Paskett E.D. , Stump T.E. , Biederman E.B. , Vachon E. , Katz M.L. , Rawl S.M. , Baltic R.D. , Kettler C.D. , Seiber E.E. , et al. .
Source: JAMA network open, 2023-04-03; 6(4), p. e2311004.
EPub date: 2023-04-03.
PMID: 37115541
Related Citations

Increasing breast, cervical, and colorectal cancer screening among rural women: Baseline characteristics of a randomized control trial.
Authors: Biederman E. , Baltic R. , Katz M.L. , Rawl S. , Vachon E. , Monahan P.O. , Stump T.E. , Kettler C. , Carter L. , Young G. , et al. .
Source: Contemporary clinical trials, 2022 Dec; 123, p. 106986.
EPub date: 2022-10-31.
PMID: 36328234
Related Citations

The Effect of Two Interventions to Increase Breast Cancer Screening in Rural Women.
Authors: Champion V.L. , Monahan P.O. , Stump T.E. , Biederman E.B. , Vachon E. , Katz M.L. , Rawl S.M. , Baltic R.D. , Kettler C.D. , Zaborski N.L. , et al. .
Source: Cancers, 2022-09-07; 14(18), .
EPub date: 2022-09-07.
PMID: 36139515
Related Citations

Maximum and Time-Dependent Body Mass Index and Breast Cancer Incidence Among Postmenopausal Women in the Black Women's Health Study.
Authors: Gathirua-Mwangi W.G. , Palmer J.R. , Champion V. , Castro-Webb N. , Stokes A.C. , Adams-Campbell L. , Marley A.R. , Forman M.R. , Rosenberg L. , Bertrand K.A. .
Source: American journal of epidemiology, 2022-03-24; 191(4), p. 646-654.
PMID: 35020804
Related Citations

An RCT to Increase Breast and Colorectal Cancer Screening.
Authors: Champion V.L. , Christy S.M. , Rakowski W. , Lairson D.R. , Monahan P.O. , Gathirua-Mwangi W.G. , Stump T.E. , Biederman E.B. , Kettler C.D. , Rawl S.M. .
Source: American journal of preventive medicine, 2020 Aug; 59(2), p. e69-e78.
PMID: 32690203
Related Citations

Psychometric development of a new body image scale for breast cancer survivors.
Authors: Biederman E. , Cohee A. , Monahan P. , Stump T. , Champion V. .
Source: Health care for women international, 2020 Apr; 41(4), p. 397-411.
EPub date: 2019-06-25.
PMID: 31237491
Related Citations

A conjoint analysis study on self-sampling for human papillomavirus (HPV) testing characteristics among black women in Indiana.
Authors: Biederman E. , Champion V. , Zimet G. .
Source: BMC women's health, 2020-03-19; 20(1), p. 55.
EPub date: 2020-03-19.
PMID: 32192493
Related Citations

A Randomized Trial to Compare a Tailored Web-Based Intervention and Tailored Phone Counseling to Usual Care for Increasing Colorectal Cancer Screening.
Authors: Champion V.L. , Christy S.M. , Rakowski W. , Gathirua-Mwangi W.G. , Tarver W.L. , Carter-Harris L. , Cohee A.A. , Marley A.R. , Jessup N.M. , Biederman E. , et al. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2018 Dec; 27(12), p. 1433-1441.
EPub date: 2018-09-04.
PMID: 30181203
Related Citations

Associations of metabolic syndrome and C-reactive protein with mortality from total cancer, obesity-linked cancers and breast cancer among women in NHANES III.
Authors: Gathirua-Mwangi W.G. , Song Y. , Monahan P.O. , Champion V.L. , Zollinger T.W. .
Source: International journal of cancer, 2018-08-01; 143(3), p. 535-542.
EPub date: 2018-03-14.
PMID: 29488212
Related Citations

Clinical and Genetic Risk Factors for Adverse Metabolic Outcomes in North American Testicular Cancer Survivors.
Authors: Zaid M.A. , Gathirua-Mwangi W.G. , Fung C. , Monahan P.O. , El-Charif O. , Williams A.M. , Feldman D.R. , Hamilton R.J. , Vaughn D.J. , Beard C.J. , et al. .
Source: Journal of the National Comprehensive Cancer Network : JNCCN, 2018 Mar; 16(3), p. 257-265.
PMID: 29523664
Related Citations

Changes in Adult BMI and Waist Circumference Are Associated with Increased Risk of Advanced Colorectal Neoplasia.
Authors: Gathirua-Mwangi W.G. , Monahan P. , Song Y. , Zollinger T.W. , Champion V.L. , Stump T.E. , Imperiale T.F. .
Source: Digestive diseases and sciences, 2017 Nov; 62(11), p. 3177-3185.
EPub date: 2017-10-05.
PMID: 28983748
Related Citations

Metabolic syndrome and total cancer mortality in the Third National Health and Nutrition Examination Survey.
Authors: Gathirua-Mwangi W.G. , Monahan P.O. , Murage M.J. , Zhang J. .
Source: Cancer causes & control : CCC, 2017 Feb; 28(2), p. 127-136.
EPub date: 2017-01-17.
PMID: 28097473
Related Citations

Back to Top