title: Process evaluation in an intervention designed to improve rates of colorectal cancer screening in a VA medical center.
abstract: Colorectal cancer (CRC) is the third most common cancer in the United States. Although CRC screening is recommended for individuals 50 years and older, screening completion rates are low. This can be attributed to provider and patient barriers. We developed an intervention to improve provider recommendation and patient screening among noncompliant male veterans in a 2-year randomized controlled trial and examined the relationship between participation and study outcomes among patients and providers. Overall, providers who attended intervention sessions recommended CRC screening during 64% of patient visits and providers who did not attend any intervention sessions recommended screening during 54% of visits (p < .01). Patients of providers who attended intervention sessions also were more likely to be screened (42% versus 29%, p < .05). The patient intervention did not have the desired impact. The subgroup of patients in the patient intervention was not more likely to complete CRC screening.
authors.affiliation: University of Illinois at Chicago, Section of Health Promotion Research, Department of Medicine, IL 60608, USA. mlf@uic.edu
authors.forename: Marian L
authors.initials: ML
authors.lastname: Fitzgibbon
authors.forename: M Rosario
authors.initials: MR
authors.lastname: Ferreira
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Dolan
authors.forename: Terry C
authors.initials: TC
authors.lastname: Davis
authors.forename: Alfred W
authors.initials: AW
authors.lastname: Rademaker
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.forename: Dachao
authors.initials: D
authors.lastname: Liu
authors.forename: Nicolle
authors.initials: N
authors.lastname: Gorby
authors.forename: Brian P
authors.initials: BP
authors.lastname: Schmitt
authors.forename: Charles L
authors.initials: CL
authors.lastname: Bennett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002641:Chicago; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D017144:Focus Groups; D006266:Health Education / Q000379:methods* / Q000706:statistics & numerical data; D006787:Hospitals, Veterans; D006801:Humans; D007318:Inservice Training; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D008875:Middle Aged; D009780:Occult Blood; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*; D017064:Process Assessment, Health Care; D011369:Professional-Patient Relations; D015397:Program Evaluation; D012812:Sigmoidoscopy / Q000706:statistics & numerical data; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*