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Process Evaluation in an Intervention Designed to Improve Rates of Colorectal Cancer Screening in a VA Medical Center

Center for Management of Complex Chronic Care, Jesse Brown Veterans Affairs Medical Center, Department of Medicine at the University of Illinois at Chicago

M. Rosario Ferreira, MD, MAPP

division of gastroenterology at Northwestern University Feinberg School of Medicine and Research Investigator at the Center for Management of Complex Chronic Care, Jesse Brown VA Medical Center, Chicago

Nancy C. Dolan, MD

Department of Preventive Medicine at Northwestern University Feinberg School of Medicine, Chicago

Terry C. Davis, PhD

Louisiana State University Health Sciences Center, Behavioral Science Section at Feist-Weiller Cancer Center, Shreveport

Alfred W. Rademaker, PhD

Department of Preventive Medicine at Northwestern University Feinberg School of Medicine and The Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago

Michael S. Wolf, PhD, MPH

Department of Preventive Medicine at Northwestern University Feinberg School of Medicine, Chicago

Dachao Liu, MS

Department of Preventive Medicine at Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago

Nicolle Gorby, BA

Northwestern University Feinberg School of Medicine, the Center for Management of Complex Chronic Care, Jesse Brown VA Medical Center, Chicago

Brian P. Schmitt, MD, MPH

VA Chicago Health Care System and Research Investigator at the Center for Management of Complex Chronic Care, Jesse Brown VA Medical Center, Chicago

Charles L. Bennett, MD, PhD

Center for Management of Complex Chronic Care, Jesse Brown Veterans Affairs Medical Center (Lakeside), Division of Hematology/Oncology at Northwestern University Feinberg School of Medicine, Chicago

Colorectal cancer (CRC) is the third most common cancer in the United States. Although CRC screening is recommended for individuals 50 years and older, screening completion rates are low. This can be attributed to provider and patient barriers. We developed an intervention to improve provider recommendation and patient screening among noncompliant male veterans in a 2-year randomized controlled trial and examined the relationship between participation and study outcomes among patients and providers. Overall, providers who attended intervention sessions recommended CRC screening during 64% of patient visits and providers who did not attend any intervention sessions recommended screening during 54% of visits (p < .01). Patients of providers who attended intervention sessions also were more likely to be screened (42% versus 29%, p < .05). The patient intervention did not have the desired impact. The subgroup of patients in the patient intervention was not more likely to complete CRC screening.

Key Words: colorectal cancer • screening • intervention

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