title: Use of cancer control referrals by 2-1-1 callers: a randomized trial.
abstract: BACKGROUND
  Callers to 2-1-1 have greater need for and lesser use of cancer control services than other Americans. Integrating cancer risk assessment and referrals to preventive services into 2-1-1 systems is both feasible and acceptable to callers.
  
  
  OBJECTIVE
  To determine whether callers will act on these referrals.
  
  
  METHODS
  In a randomized trial, 2-1-1 callers (n=1200) received standard service and those with at least one cancer risk factor or need for screening were assigned to receive verbal referrals only, verbal referrals + a tailored reminder mailed to their home, or verbal referrals + a telephone health coach/navigator. All data were collected from June 2010 to March 2012 and analyzed in March and April 2012.
  
  
  RESULTS
  At 1-month follow-up, callers in the navigator condition were more likely to report having contacted a cancer control referral than those receiving tailored reminders or verbal referrals only (34% vs 24% vs 18%, respectively; n=772, p<0.0001). Compared to verbal referrals only, navigators were particularly effective in getting 2-1-1 callers to contact providers for mammograms (OR=2.10, 95% CI=1.04, 4.22); Paps (OR=2.98, 95% CI=1.18, 7.54); and smoking cessation (OR=2.07, 95% CI=1.14, 3.74).
  
  
  CONCLUSIONS
  Given the extensive reach of 2-1-1s and the elevated risk profile of their callers, even modest response rates could have meaningful impact on population health if proactive health referrals were implemented nationally.
authors.affiliation: Health Communication Research Laboratory, Brown School, Washington University in St Louis, Missouri 63112-1408, USA. mkreuter@gwbmail.wustl.edu
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Kreuter
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Eddens
authors.forename: Kassandra I
authors.initials: KI
authors.lastname: Alcaraz
authors.forename: Suchitra
authors.initials: S
authors.lastname: Rath
authors.forename: Choi
authors.initials: C
authors.lastname: Lai
authors.forename: Nikki
authors.initials: N
authors.lastname: Caito
authors.forename: Regina
authors.initials: R
authors.lastname: Greer
authors.forename: Nikisha
authors.initials: N
authors.lastname: Bridges
authors.forename: Jason Q
authors.initials: JQ
authors.lastname: Purnell
authors.forename: Anjanette
authors.initials: A
authors.lastname: Wells
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.forename: Colleen
authors.initials: C
authors.lastname: Walsh
authors.forename: Erin
authors.initials: E
authors.lastname: Eckstein
authors.forename: Julia
authors.initials: J
authors.lastname: Griffith
authors.forename: Alissa
authors.initials: A
authors.lastname: Nelson
authors.forename: Cicely
authors.initials: C
authors.lastname: Paine
authors.forename: Tiffany
authors.initials: T
authors.lastname: Aziz
authors.forename: Anne M
authors.initials: AM
authors.lastname: Roux
mesh_terms: D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007255:Information Services / Q000458:organization & administration*; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data; D009369:Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D011314:Preventive Health Services / Q000379:methods*; D012017:Referral and Consultation / Q000458:organization & administration*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016540:Smoking Cessation / Q000706:statistics & numerical data; D013689:Telephone