An intensive outreach program targeting vulnerable patients dramatically improved screening rates for colorectal cancer, according to a new study supported by the Agency for Healthcare Research and Quality.

Based on the findings, comprehensive outreach programs run through community health centers hold great promise in reducing preventable deaths due to colorectal cancer.

The study, published in JAMA Internal Medicine, found that community health center patients who received outreach via mail, automated phone and text messages, and calls by a health center staff member were more than twice as likely to complete an at-home colon cancer screening test. This was the case even though most patients in the study were poor and uninsured, and had limited English proficiency and low understanding of health information.

The patients were divided into a usual care group and an intervention group. Usual care included computerized reminders, standing orders to give patients home tests and feedback to providers on their screening rates. The intervention group received usual care plus:

*A mailed reminder letter, a free home test with low-literacy instructions and a postage-paid return envelope

*Automated phone and text messages reminding them that they were due for screening and that a home test was being mailed to them

*Automated phone and text reminders two weeks later for those who did not return the home test

*Personal outreach from a trained professional after three months if a test was not completed

The researchers found that the intervention was very successful, with 82.2 percent of the patients in the intervention group completing the fecal occult blood test within six months of the screening due date versus 37.3 percent of the patients in the usual care group.

"The intervention greatly increased adherence to annual CRC screening; most screenings were achieved without personal calls," the authors concluded. "It is possible to improve annual CRC screening for vulnerable populations with relatively low-cost strategies that are facilitated by health information technologies."

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