A Media and Clinic Intervention to Increase Colorectal Cancer Screening in Ohio Appalachia.
OBJECTIVE
To test the effectiveness of a colorectal cancer (CRC) screening intervention among adults living in Ohio Appalachia.


METHODS
We conducted a group-randomized trial of a county-level intervention among adults living in 12 Ohio Appalachian counties who received a media campaign and clinic intervention focused on either CRC screening or fruits and vegetables. Participants' percentage within CRC screening guidelines was assessed with cross-sectional surveys conducted annually for four years, and validated with medical record review of screening.


RESULTS
On average, screening data were obtained on 564 intervention and 559 comparison participants per year. There was no difference in the Wave 4 CRC screening rates of intervention and comparison counties (35.2% versus 31.4%). Multivariate analyses found that high perceived risk of CRC, willingness to have a CRC test if recommended by a doctor, doctor recommendation of a CRC screening test, and patient-physician communication about changes in bowel habits, family history of CRC, and eating fruits and vegetables were significant (p < 0.05) predictors of being within CRC screening guidelines.


CONCLUSIONS
The intervention was not effective in increasing CRC rates among Ohio Appalachian adults. Future research should determine how media and clinic-based interventions can be modified to improve CRC screening rates among this underserved population.
Comprehensive Cancer Center, The Ohio State University, 1590 N. High Street, Suite 525, Columbus, OH 43201, USA.
Jessica L
JL
Krok-Schoen
Comprehensive Cancer Center, The Ohio State University, 1590 N. High Street, Suite 525, Columbus, OH 43201, USA ; Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, 395 W. 12th Avenue, Columbus, OH 43210, USA ; Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA.
Mira L
ML
Katz
Comprehensive Cancer Center, The Ohio State University, 1590 N. High Street, Suite 525, Columbus, OH 43201, USA.
Jill M
JM
Oliveri
Center for Biostatistics, The Ohio State University, 1800 Cannon Drive, Columbus, OH 43210, USA.
Gregory S
GS
Young
Division of Biostatistics, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA.
Michael L
ML
Pennell
Comprehensive Cancer Center, The Ohio State University, 1590 N. High Street, Suite 525, Columbus, OH 43201, USA ; Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, 395 W. 12th Avenue, Columbus, OH 43210, USA.
Paul L
PL
Reiter
Biobehavioral Cancer Prevention and Control Training Program, University of Washington, P.O. Box 359455, Seattle, WA 98195, USA.
Jesse J
JJ
Plascak
School of Communication, The Ohio State University, 3022 Derby Hall, 154 N. Oval Mall, Columbus, OH 43210, USA.
Michael D
MD
Slater
STEM Translational Communication Program, University of Florida, 2088 Weimer Hall, 1885 Stadium Road, Gainesville, FL 32611, USA.
Janice L
JL
Krieger
Comprehensive Cancer Center, The Ohio State University, 1590 N. High Street, Suite 525, Columbus, OH 43201, USA.
Cathy M
CM
Tatum
Comprehensive Cancer Center, The Ohio State University, 1590 N. High Street, Suite 525, Columbus, OH 43201, USA ; Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, 395 W. 12th Avenue, Columbus, OH 43210, USA ; Division of Epidemiology, College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA.
Electra D
ED
Paskett
D000328:Adult; D000368:Aged; D001061:Appalachian Region; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003146:Communications Media; D055088:Early Detection of Cancer / Q000639:trends*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000639:trends*; D008875:Middle Aged; D009820:Ohio