Promoting Colorectal Cancer Screening in Rural Emergency Departments


This trial will compare the effects of a culturally targeted intervention designed to assist participants to identify and overcome individual barriers to colorectal cancer (CRC) and to promote CRC screenings using motivational interviewing (Ml) delivered by a lay health advisor (LHA) compared to the current standard-of-care (distribution of a brochure describing CRC screening services offered by the hospital) on CRC screening compliance.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Health Services Research
    • Masking: None (Open Label)
  • Study Primary Completion Date: May 30, 2018

Detailed Description

The specific aim of this project is to adapt and pilot a tailored intervention to promote CRC screenings in a rural Appalachian Kentucky emergency department (ED) in order to: (a) evaluate the feasibility of providing a cancer screening promotion intervention in an emergency department (ED) that serves a rural Appalachian community; and (b) assess the effects of the intervention on barriers to CRC screening, stage of readiness to screen and CRC screening engagement. The first phase of the project will involve the adaptation and pretesting of the intervention. This phase will take approximately 6 months. The second phase of the project will involve piloting the intervention and evaluating its efficacy and feasibility and will take place over the following 18 months. We will conduct a randomized controlled trial to examine the efficacy and feasibility of delivering the LHA delivered MI intervention to promote CRC screening in persons waiting in a rural Appalachian emergency department (ED) for non urgent complaints. We will evaluate efficacy by measurement of CRC screening status at baseline and three and six months post intervention.


  • Behavioral: Motivational interview
    • A lay health advisor will engage the subject in a motivational interview to promote the importance of colorectal cancer screening
  • Behavioral: Standard of care
    • A lay health advisor will provide the subject with a brochure promoting the importance of colorectal cancer screening

Arms, Groups and Cohorts

  • Experimental: Motivational Interview
    • Subjects will engage in a brief motivational interview to establish an action plan and discuss follow-up interviews a 3 and 6 months post ED visit
  • Active Comparator: Standard of Care
    • Subjects will be provided a standard of care colorectal cancer screening brochure at the time of ED visit

Clinical Trial Outcome Measures

Primary Measures

  • Change in colorectal cancer screening rate
    • Time Frame: 6 months
    • Number of participants that seek out colorectal cancer screening after a motivational interview with a lay health advisor compared to standard of care (being provided a screening brochure)

Participating in This Clinical Trial

Inclusion Criteria

1. 50+ years of age

2. Rural Appalachian resident

3. No personal history of colorectal cancer

4. No cognitive impairment

5. Ability to speak and understand English

6. Has not had one of the following colorectal cancer screening tests-

1. Fecal Occult Blood Test within the past year

2. Flexible sigmoidoscopy within the past five years, or

3. Colonoscopy within the past ten years

Exclusion Criteria

Gender Eligibility: All

Minimum Age: 50 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • University of Kentucky
  • Provider of Information About this Clinical Study
    • Principal Investigator: Jennifer Hatcher, Principal Investigator – University of Kentucky
  • Overall Official(s)
    • Jennifer Hatcher, RN, PhD, Principal Investigator, University of Kentucky
  • Overall Contact(s)
    • Jennifer Hatcher, RN, PhD, 859-257-5263,

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