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document
A randomized controlled trial to improve colon cancer screening in rural family medicine : an Iowa Research Network ( IRENE ) study . BACKGROUND Many adults have not been screened for colon cancer , a potentially preventable cause of death . METHODS This was a randomized controlled trial conducted between December 2008 and April 2011 to improve CRC screening in 16 rural family physician offices . Subjects due for CRC screening were randomized within each practice to 1 of 4 groups : ( 1 ) usual care ; ( 2 ) physician chart reminder ; ( 3 ) physician chart reminder , mailed education , CRC reminder magnet , and fecal immunochemical test ( FIT ) ( mailed education/FIT ) ; or ( 4 ) all the preceding plus a structured telephone call to the patient from project staff to provide education , assess interest in screening , explain the screening tests , and address barriers ( mailed education/FIT plus phone call ) . The main outcome was completion of any CRC screening . RESULTS This study enrolled 743 patients . CRC screening was completed by 17.8 % in the usual care group , 20.5 % in the chart reminder group , 56.5 % in the mailed education/FIT group , and 57.2 % in the mailed education/FIT plus phone call group . We found no effect from the chart reminder compared with usual care ( odds ratio [ OR ] , 1.2 ; 95 % confidence interval [ CI ] , 0.7-2.0 ) ; and a beneficial effect from the mailed education/FIT ( OR , 6.0 ; 95 % CI , 3.7-9.6 ) and the mailed education/FIT plus phone call ( OR , 6.2 ; 95 % CI , 3.8-9.9 ) . Both FIT and colonoscopy rates increased significantly in both mailed education groups . CONCLUSION CRC screening rates increased significantly among patients who were overdue for screening after they received mailed educational materials and a FIT . The addition of a phone call did not further increase screening rates .
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Intervention_Educational
colon cancer screening
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Intervention_Educational
usual care
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Intervention_Educational
( 2 ) physician chart reminder
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Intervention_Educational
( 3 ) physician chart reminder
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Intervention_Educational
mailed education
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Intervention_Educational
CRC reminder magnet
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Intervention_Educational
fecal immunochemical test ( FIT ) ( mailed education/FIT )
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Intervention_Educational
( 4 ) all the preceding plus a structured telephone call to the patient from project staff to provide education
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Intervention_Educational
assess interest in screening , explain the screening tests , and address barriers
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Outcome_Other
completion of any CRC screening .
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Outcome_Other
completed
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Outcome_Other
beneficial effect
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Outcome_Other
FIT and colonoscopy rates increased
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Outcome_Other
CRC screening rates
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Participant_Condition
rural family
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Participant_Condition
CRC screening
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Participant_Sample-size
743