The Effect of a Tailored Educational Flyer on Colorectal Cancer Screening Among Rural Residents: Lessons Learned from...

Area of Science:

• Public Health
• Preventive Medicine
• Health Disparities

Background:

• Colorectal cancer (CRC) screening is crucial for early detection and prevention.
• Stool-based tests, like the fecal immunochemical test (FIT), are effective screening tools.
• Mailed FIT interventions show promise for increasing CRC screening, especially in rural areas.

Purpose of the Study:

• To evaluate the effectiveness of a tailored educational flyer in improving CRC screening uptake via mailed FIT kits among rural US residents.
• To identify predictors of FIT kit return in this population.

Main Methods:

• A randomized controlled trial involving 1230 rural Nebraskans aged 45-74 who were not up-to-date on CRC screening.
• Participants were mailed FIT kits; half also received a tailored, one-page, gender-specific educational flyer.
• Logistic regression analysis was used to determine predictors of FIT kit return.

Main Results:

• Overall FIT kit return rate was 15.6% (16.1% in the flyer group, 15.1% in the no-flyer group).
• No significant difference in FIT kit return rates was observed between the flyer and no-flyer groups (AOR: 1.21; 95% CI: 0.88-1.66).
• Females and older adults (65-74) were more likely to return FIT kits compared to males and younger adults (45-54).

Conclusions:

• A tailored educational flyer did not enhance CRC screening rates through a mailed FIT intervention in rural populations.
• Future research should investigate content, timing, and delivery methods for educational interventions.
• Targeted strategies for males and younger adults (45-54) may be necessary to improve CRC screening uptake.