TY  - JOUR
AU  - Haverkamp, Donald
AU  - English, Kevin
AU  - Jacobs-Wingo, Jasmine
AU  - Tjemsland, Amanda
AU  - Espey, David
PY  - 2020
TI  - Effectiveness of Interventions to Increase Colorectal Cancer Screening Among American Indians and Alaska Natives
T2  - Preventing Chronic Disease
JO  - Prev Chronic Dis
SP  - E62
VL  - 17
CY  - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2  - INTRODUCTION  Screening rates for colorectal cancer are low in many American Indian and Alaska Native (AI/AN) communities. Direct mailing of a fecal immunochemical test (FIT) kit can address patient and structural barriers to screening. Our objective was to determine if such an evidence-based intervention could increase colorectal cancer screening among AI/AN populations. METHODS  We recruited study participants from 3 tribally operated health care facilities and randomly assigned them to 1 of 3 study groups: 1) usual care, 2) mailing of FIT kits, and 3) mailing of FIT kits plus follow-up outreach by telephone and/or home visit from an American Indian Community Health Representative (CHR). RESULTS  Among participants who received usual care, 6.4% returned completed FIT kits. Among participants who were mailed FIT kits without outreach, 16.9% returned the kits - a significant increase over usual care (P < .01). Among participants who received mailed FIT kits plus CHR outreach, 18.8% returned kits, which was also a significant increase over usual care (P < .01) but not a significant increase compared with the mailed FIT kit-only group (P = .44). Of 165 participants who returned FIT kits during the study, 39 (23.6%) had a positive result and were referred for colonoscopy of which 23 (59.0%) completed the colonoscopy. Twelve participants who completed a colonoscopy had polyps, and 1 was diagnosed with colorectal cancer. CONCLUSION  Direct mailing of FIT kits to eligible community members may be a useful, population-based strategy to increase colorectal cancer screening among AI/AN people.
SN  - 1545-1151
UR  - https://doi.org/10.5888/pcd17.200049
DO  - 10.5888/pcd17.200049
ER  - 
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