Related Experiment Video
Updated: Jul 11, 2026
E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
A randomized controlled trial of the impact of targeted and tailored interventions on colorectal cancer screening
Ronald E Myers1, Randa Sifri, Terry Hyslop
1Department of Medical Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. Ron.myers@mail.tju.edu
Background:
Colorectal cancer screening is underutilized. The objective of the current study was to determine whether targeted and tailored interventions can increase screening use.
Methods:
A total of 1546 primary care practice patients completed a baseline telephone survey and were randomized to 4 study groups: control (387 patients), Standard Intervention (SI) (387 patients), Tailored Intervention (TI) (386 patients), or Tailored Intervention plus Phone (TIP) (386 patients). The control group received usual care throughout the study. The SI group received a targeted intervention by mail (ie, screening invitation letter, informational booklet, stool blood test, and reminder letter). The TI group received the targeted intervention with tailored "message pages." The TIP group received the targeted intervention, tailored message pages, and a telephone reminder. Intervention group contacts were repeated 1 year later. Screening was assessed 24 months after randomization.
Results:
Screening rates in study groups were 33% in the control group, 46% in the SI group, 44% in the TI group, and 48% in the TIP group. Screening was found to be significantly higher in all 3 intervention groups compared with the control group (odds ratio [OR] of 1.7 [95% confidence interval (95% CI), 1.3-2.5], OR of 1.6 [95% CI, 1.2-2.1], and OR of 1.9 [95% CI, 1.4-2.6], respectively), but did not vary significantly across intervention groups. Multivariate analyses demonstrated that older age, education, past cancer screening, screening preference, response efficacy, social support and influence, and exposure to study interventions were positive predictors of screening. Having worries and concerns about screening was found to be a significant negative predictor.
Conclusions:
Targeted and tailored interventions were found to increase colorectal cancer screening use. However, additional research is needed to determine how to increase the effect of such interventions in primary care.
Insights
Targeted and tailored interventions effectively increased colorectal cancer screening rates in primary care. Further research is needed to enhance intervention effectiveness.
Area of Science:
- Public Health
- Preventive Medicine
- Health Services Research
Background:
- Colorectal cancer screening remains underutilized in primary care settings.
- Effective strategies are needed to improve screening uptake.
- This study evaluated targeted and tailored interventions to boost screening rates.
Purpose of the Study:
- To determine if targeted and tailored interventions can increase colorectal cancer screening utilization.
- To compare the effectiveness of different intervention strategies.
Main Methods:
- 1546 primary care patients were randomized into four groups: control, Standard Intervention (SI), Tailored Intervention (TI), and Tailored Intervention plus Phone (TIP).
- Interventions involved mailed invitations, informational materials, stool blood tests, reminder letters, tailored messages, and phone calls.
- Screening was assessed at 24 months post-randomization.
Main Results:
- Screening rates were 33% (control), 46% (SI), 44% (TI), and 48% (TIP).
- All intervention groups showed significantly higher screening rates compared to the control group (ORs ranging from 1.6 to 1.9).
- Older age, higher education, prior screening, and perceived efficacy were positive predictors; screening concerns were a negative predictor.
Conclusions:
- Targeted and tailored interventions successfully increased colorectal cancer screening use.
- Further research is necessary to optimize these interventions for greater impact in primary care settings.
