Colorectal cancer is the 2nd leading cause of cancer deaths in the U.S. Although colorectal cancer screening (CRCS) is effective, cost-effective and consistently recommended by clinical practice guidelines, only 57.3% of the adults over 50 years have been screened within the recommended interval. Preliminary research conducted by this PI demonstrates that approximately 90% of patients who have not had CRCS report that a doctor's recommendation would motivate them to undergo screening (AHRQ Minority Supplement to grant R01 HS 10299). However, research also shows that physicians do not consistently recommend CRCS to each eligible patient. In this proposal, the PI builds upon her scholarship in the barriers of and facilitators to physician recommendation of CRCS (NCI K01 CA 97925) to propose a randomized controlled trial that will pilot test an interactive, multifaceted, Web-based intervention (""""""""eToolbox"""""""") to increase primary care physician rates of CRCS. This application innovatively proposes to pilot test the eToolbox in the setting of the American Board of Internal Medicine (ABIM) Maintenance of Certification process within the Preventive Services Practice Improvement Module, a physician-directed measurement of their performance and quality improvement requirement for board recertification.
The specific aims of this application are to: 1) To test the eToolbox intervention in a randomized, controlled trial to determine if it increases CRCS rates;and 2) To explore the effect of each intervention (revised PIM alone vs. PIM + eToolbox) on the type of physician-directed practice improvement plan to increase CRCS. This NCI Transition Career Development Award to Promote Diversity (K22) proposal will facilitate the career transition of Dr. Carmen E. Guerra, MD, MSCE, Assistant Professor of Medicine and current recipient of NCI Mentored Career Development Award for Underrepresented Minorities by allowing her to collect pilot data to support, prepare, submit and hopefully receive her first R01 to test the effectiveness of the proposed Webbased intervention in increasing CRCS rates when embedded in the recertification processes of the ABIM and the American Academy of Family Practice. The significance of this research is that it fulfills a great public health need for interventions that promise to increase CRCS rates and thereby has the potential to reduce colorectal cancer incidence, morbidity and mortality.
| Guerra, Carmen E; Sherman, Melani; Armstrong, Katrina (2009) Diffusion of breast cancer risk assessment in primary care. J Am Board Fam Med 22:272-9 |
