ASPO Abstracts
Increasing Access and Compliance to At-home Colorectal Cancer Screening in Rural Communities through Online Education and the Postal Service
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Colorectal cancer (CRC) is the third most common cancer diagnosed in the U.S. Efforts to increase CRC screening rates among rural communities is a priority, where significant CRC disparities exist. Utah has a significant rural population, with only 8% of the landmass designated as urban. Rural cancer health disparities–often stemming from less education and increased distance between home and care facilities–led Huntsman Cancer Institute (HCI) to address this with National Cancer Institute (NCI) funding. HCI implemented Screen to Save (S2S), with a focus on two interventions to address CRC screening rates: 1) providing and promoting a CRC virtual education module to patients who have recently visited a clinic and are due for CRC screening; 2) upon completion of the education, sending an at-home FOBT kit via mail to patients' homes and facilitating return of the completed test. The framework is designed to increase CRC screening rates through informed decision making, with screening messaging framed as a positive action that can be done in the comfort of home. The education component addresses common myths and barriers to completing screening and highlights follow-up needs based on results from the at-home test. The education module includes four parts: 1) demographic information 2) baseline knowledge test 3) interactive video about CRC 4) post-education test. The module is designed to be completed via cell phone, computer, or tablet, online and at the pace the patient prefers or via phone in the absence of internet. Over a one-year pilot, compliance rates for at-home colorectal cancer screening rose from 14% to 72% at the rural pilot clinic. Furthermore, 100% (14) of patients who received a positive result completed necessary steps to receive a follow-up colonoscopy, where more than half were found to have precancerous polyps. The average score on the baseline knowledge test was 62%, while the post-education test scores were 90%, further demonstrating a dramatic increase in understanding of CRC which corresponds with the substantial increase in compliance rates. Due to the positive impacts of this study, this framework is now being implemented at several other clinics to address health equity barriers to care.
Keywords: Colorectal Cancer, Education, Virtual, Disparities, Navigation