title: Effectiveness of three interventions to improve participation in colorectal cancer screening.
abstract: OBJECTIVE
  Participation in colorectal cancer (CRC) screening varies widely among different countries and different socio-demographic groups. Our objective was to assess the effectiveness of three primary-care interventions to increase CRC screening participation among persons over the age of 50 years and to identify the health and socio-demographic-related factors that determine greater participation.
  
  
  METHODS
  We conducted a randomized experimental study with only one post-test control group. A total of 1,690 subjects were randomly distributed into four groups: written briefing; telephone briefing; an invitation to attend a group meeting; and no briefing. Subjects were evaluated 2 years post-intervention, with the outcome variable being participation in CRC screening.
  
  
  RESULTS
  A total of 1,129 subjects were interviewed. Within the groups, homogeneity was tested in terms of socio-demographic characteristics and health-related variables. The proportion of subjects who participated in screening was: 15.4% in the written information group (95% confidence interval [CI]: 11.2-19.7); 28.8% in the telephone information group (95% CI: 23.6-33.9); 8.1% in the face-to-face information group (95% CI: 4.5-11.7); and 5.9% in the control group (95% CI: 2.9-9.0), with this difference proving statistically significant (p < 0.001). Logistic regression showed that only interventions based on written or telephone briefing were effective. Apart from type of intervention, number of reported health problems and place of residence remained in the regression model.
  
  
  CONCLUSIONS
  Both written and telephone information can serve to improve participation in CRC screening. This preventive activity could be optimized by means of simple interventions coming within the scope of primary health-care professionals.
authors.affiliation: Atención Primaria, Centro de Salud Zona IV. Albacete, ESPAÑA.
authors.forename: Jesús
authors.initials: J
authors.lastname: López-Torres Hidalgo
authors.affiliation: Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha.
authors.forename: Joseba
authors.initials: J
authors.lastname: Rabanales Sotos
authors.affiliation: Centro de Salud de Villarrobledo, Albacete.
authors.forename: María José
authors.initials: MJ
authors.lastname: Simarro Herráez
authors.affiliation: Hospital Universitario y Politécnica La Fe, Valencia.
authors.forename: Jaime
authors.initials: J
authors.lastname: López-Torres López
authors.affiliation: Servicio de Farmacia, Gerencia de Atención Integrada de Albacete.
authors.forename: Monchi
authors.initials: M
authors.lastname: Campos Rosa
authors.affiliation: Servicio de Prevención de Riesgos Laborales, Complejo Hospitalario Universitario de Albacete.
authors.forename: María Ángeles
authors.initials: MÁ
authors.lastname: López Verdejo
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D055088:Early Detection of Cancer; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D013689:Telephone