Abstract B108: “GET SCREENED”: A randomized trial of reminders, recall, and outreach (RRO) to improve cancer screening in safety-net primary care practices Free

Background: Members of racial and ethnic groups and persons with low socioeconomic status (SES) tend to be diagnosed at later stages of cancer and experience higher cancer related mortality. Overall rates of cancer screening have improved, but there has been only modest improvement in disparities in screening. A practice-based intervention using a combination of repeated reminders, recall and outreach (RRO) has been shown to significantly improve child and adult immunizations within safety net practices and reduce community wide disparities. We hypothesized that a similar approach could improve cancer screening in primary care practices that service predominantly minority and low SES patients.

Objective: To measure the efficacy of RRO on cancer screening rates within a large practice serving low income minority patients.

Methods: A patient-level randomized controlled trial was conducted within a family practice serving large numbers of minority and low SES patients. Eligibility criteria included (1) being a registered patient at the practice; (2) having at least 1 visit in the last 2 years; (3) age 40-75 for Breast Cancer (BC) screening and 50-75 for Colorectal Cancer (CRC) screening; (4) being past due for BC screening, CRC screening or both. Patients were assigned based on their medical record number to either intervention or usual care. The intervention included reminders (repeated point of care prompts to patients and their providers), recall (personalized letters to patients) and outreach (follow-up phone calls and mailed fecal occult blood testing kits). Relevant patient information was abstracted from the electronic medical record and imported into a customized patient tracking registry created in MicrsoftAccess™.

Results: Of 3,528 appropriately-aged patients in the practice, 2,389 were overdue for screening and met the eligibility criteria (1730 female; 686 male). At the end of the study period, the BC screening rate was 17% among controls vs 41% in the intervention group (p<0.0001); the CRC screening rates were 10% vs 30% (control vs intervention, p<0.0001).

Conclusion: Practice-based RRO significantly improves cancer screening among largely low income and minority patient population.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B108.