Multi-Level Interventions in Follow-Up in Reducing Rural Colon Cancer Disparities in Participants with Abnormal Screening Tests

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Status: Active


This trial studies how well multi-level interventions in follow-up work in reducing rural colon cancer disparities in participants with abnormal screening tests. Learning about the current processes used to support and monitor colorectal cancer screening, from initiation to results, and through documentation of the recommended screening interval after a diagnostic colonoscopy, may help doctors to develop better screening processes and screening follow-up.

Eligibility Criteria

Inclusion Criteria

  • Positive FOBT during the study period
  • No medical contra-indication for colonoscopy

Locations & Contacts


Southern Illinois Healthcare-Carbondale
Status: Active
Contact: Marci Moore-Connelley
Phone: 618-457-5200ext67117


Saint Louis
Siteman Cancer Center at Washington University
Status: Active
Contact: Aimee James
Phone: 314-454-8300

Trial Objectives and Outline


I. Assess pre-implementation conditions to inform strategies that will maximize the likelihood of successful implementation of the multi-level intervention.

II. Evaluate the impact of a multi-level intervention addressing patient, provider/staff, and clinic-level factors to improve follow-up after positive fecal occult blood test (FOBT).

III. Evaluate moderation and mediation of multi-level intervention effects using mixed methods.


PARTICIPANT-LEVEL: Participants receive low-literacy educational and instructional brochures (< 7th grade level) at the time of FOBT referral. Participants with a positive FOBT receive a second low-literacy brochure on bowel preparation for colonoscopy and the importance of follow-up, and assist with scheduling and completing colonoscopy.

PRIMARY CARE PROVIDER AND STAFF-LEVEL: Providers and staff undergo trainings over 1 hour to prepare for delivery of the participant interventions and clinic-level interventions (participant tracking mechanisms and the feedback report).

CLINIC-LEVEL: Individuals identified by the clinic use participant tracking mechanisms, receive prompts to engage participants to schedule a colonoscopy, and receive a feedback report that is used for motivation to use other intervention components that will enable goals to be reached.

Trial Phase & Type

Trial Phase

No phase specified

Trial Type


Lead Organization

Lead Organization
Siteman Cancer Center at Washington University

Principal Investigator
Aimee James

Trial IDs

Primary ID 201704046
Secondary IDs NCI-2018-00296 ID NCT03457454