This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ganz, P. A. Articles by Fielding, J. Search for Related Content PubMed PubMed Citation Articles by Ganz, P. A. Articles by Fielding, J.

Improving Colorectal Cancer Screening Rates in a Managed Care Health Plan

Recruitment of Provider Organizations for a Randomized Effectiveness Trial¹

Division of Cancer Prevention and Control Research, Jonsson Comprehensive Cancer Center [P. A. G., M. M. F., J. L. M., R. B., K. L. K.], Department of Health Services, School of Public Health [P. A. G., M. M. F., R. B., J. F.], and Departments of Medicine [P. A. G., J. L. M., K. L. K.] and Pediatrics [J. F.], School of Medicine, University of California, Los Angeles, California; Blue Cross of California, Woodland Hills, California [M. B.]; Senior Scientist, RAND, Santa Monica, California [K. L. K.]; and Department of Family Medicine, Dartmouth Medical School, Hanover, New Hampshire [A. D.]

Evidence-based guidelines recommend regular colorectal cancer (CRC) screening for adults 50 years and older, yet screening rates remain very low. In this paper we describe the challenges associated with recruitment and retention of provider organizations (POs) for a group randomized, controlled effectiveness trial to increase CRC screening, among patients in a managed care health insurance plan. Using the health plan as the sampling frame, we recruited POs to test a facilitated quality improvement program to increase CRC screening. Defined eligibility and recruitment procedures were used as part of this process. We successfully recruited 36 POs over the course of 9 months; however, there were many challenges associated with the recruitment and retention process, including difficulties in (a) identifying the PO medical director and the individual authorized to agree to study participation, (b) making contact with the medical director, and (c) obtaining the materials necessary to initiate the study. All of these factors delayed the research substantially. Retention activities were also a major challenge in that one-third of the medical directors changed during the course of the intervention. This study benefited from a strong partnership between the health plan and the research group. Although many challenges exist, there are tremendous opportunities that result from the design and conduct of effectiveness research in existing POs. Successful implementation of programs that are feasible and take advantage of existing quality improvement mechanisms within the PO has potential to improve CRC screening rates and can have a major public health impact.

This article has been cited by other articles:

				D. M. Murray, S. L. Pals, J. L. Blitstein, C. M. Alfano, and J. Lehman Design and Analysis of Group-Randomized Trials in Cancer: A Review of Current Practices J Natl Cancer Inst, April 2, 2008; 100(7): 483 - 491. [Abstract] [Full Text] [PDF]

				M. L. Fitzgibbon, M. R. Ferreira, N. C. Dolan, T. C. Davis, A. W. Rademaker, M. S. Wolf, Dachao Liu, N. Gorby, B. P. Schmitt, and C. L. Bennett Process Evaluation in an Intervention Designed to Improve Rates of Colorectal Cancer Screening in a VA Medical Center Health Promot Pract, July 1, 2007; 8(3): 273 - 281. [Abstract] [PDF]

				J G Williams, S E Roberts, M F Ali, W Y Cheung, D R Cohen, G Demery, A Edwards, M Greer, M D Hellier, H A Hutchings, et al. Gastroenterology services in the UK. The burden of disease, and the organisation and delivery of services for gastrointestinal and liver disorders: a review of the evidence Gut, February 1, 2007; 56(suppl_1): 1 - 113. [Full Text] [PDF]

				S. S. Gorin, A. R. Ashford, R. Lantigua, A. Hossain, M. Desai, A. Troxel, and D. Gemson Effectiveness of Academic Detailing on Breast Cancer Screening among Primary Care Physicians in an Underserved Community J Am Board Fam Med, March 1, 2006; 19(2): 110 - 121. [Abstract] [Full Text] [PDF]