Melinda M. Davis|Michele Freeman|Jackilen Shannon|Gloria D. Coronado|Kurt C. Stange|Jeanne Marie Guise|Stephanie B. Wheeler|David I Buckley
A systematic review of clinic and community intervention to increase fecal testing for colorectal cancer in rural and low-income populations in the United States – How, what and when?
Research Network (United States)|Oregon Health & Science University|Portland VA Medical Center|Oregon Health & Science University|Oregon Clinic|Kaiser Permanente Center for Health Research|Case Western Reserve University|Oregon Health & Science University|University of North Carolina at Chapel Hill|Oregon Health & Science University
interventions improve fecal testing colorectal cancer crc exist yet routine practice conducted systematic review determine implementation strategies contextual factors influenced uptake interventions increase fecal immunochemical tests fit fecal occult blood testing fobt crc rural lowincome populations united stateswe searched medline cochrane library january 1998 july 2016 scopus clinicaltrialsgov march 2015 original articles interventions increase fecal testing crc two reviewers independently screened abstracts reviewed fulltext articles extracted data performed quality assessments qualitative synthesis described relationship changes fecal testing rates crc intervention components implementation strategies contextual factors technical expert panel primary care professionals health system leaders academicians guided workof 4218 citations initially identified 27 unique studies reported 29 publications met inclusion criteria studies conducted primary care n 20 741 community n 5 185 n 2 74 settings studies n 27 1000 described multicomponent interventions clinic based studies components occurred frequently among highly effectiveeffective study arms provision kits direct mail use preaddressed stamped envelope client reminders provider ordered inclinic distribution interventions delivered clinic staffcommunity members n 10 370 research staff n 6 222 n 10 370 unclear n 1 37 half studies lacked information training monitoring intervention fidelity n 15 556studies improve fitfobt rural lowincome populations utilized multicomponent interventions provision kits mail use preaddressed stamped envelopes client reminders inclinic distribution appeared frequently highly effectiveeffective clinicbased study arms studies described contextual factors implementation strategies robust application guidelines support reporting methods select adapt implement interventions help end users determine interventions work improve crc screening interventions would work best setting given specific patient populations clinical settings community characteristicsin accordance prisma guidelines systematic review protocol registered prospero international prospective register systematic reviews april 16 2015 registration number crd42015019557