A Pilot Video Intervention to Decrease Fear of Colonoscopy in a Safety-Net Healthcare System
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Colorectal Carcinoma
- Sponsor
- Fred Hutchinson Cancer Center
- Enrollment
- 66
- Locations
- 1
- Primary Endpoint
- Feasibility as measured by study accrual
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
This clinical trial compares an educational video intervention versus usual care of no video intervention in decreasing patient fear of a colonoscopy procedure after receiving a positive fecal immunochemical test (FIT). The lack of a follow-up colonoscopy after an abnormal FIT result is associated with an increased risk of colorectal cancer mortality, advanced-stage colorectal cancer, among other complications, compared to the completion of a follow-up colonoscopy. An educational video may reduce patient fear and increase knowledge, self-efficacy, and intent to complete a colonoscopy compared to the usual care of no video intervention.
Detailed Description
OUTLINE: Patients are randomized to 1 of 2 arms. ARM 1: Patients watch an educational video about the importance of abnormal FIT results, the implications if follow-up colonoscopy is not completed, and demonstrate the steps to complete a colonoscopy. ARM 2: Patients receive usual care and do not watch the educational video. After completion of study, patients are followed for 12 months after their abnormal FIT result.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age 45-75
- •Have an assigned primary care provider in our partnering safety-net health system
- •Have a billable primary care encounter between 2019-2022
- •Have an abnormal FIT result for colorectal cancer (CRC) screening without a colonoscopy within 1 year
- •Ability to communicate in English due to initial videos being available in English
Exclusion Criteria
- •Adults \< age 45 or \> age 75
- •Patients who receive care at other University of Washington (UW) medicine sites (non-safety-net patients)
- •Individuals without a primary care encounter between 2019-2022
- •Individuals whose primary language is not English
Outcomes
Primary Outcomes
Feasibility as measured by study accrual
Time Frame: Up to 12 months post-abnormal fecal immunochemical test (FIT) result
Feasibility will be measured by recruitment as the proportion of invited participants who consent and complete the pilot study.
Incidence of fear related to colonoscopy
Time Frame: Up to 12 months post-abnormal FIT result
Intervention arm patients will complete a pre- and post-intervention survey that will include questions about fear of colonoscopy. Usual care patients will complete a baseline survey on the same measures. Fear will be assessed using Manne's 6-item fear of colonoscopy scale. Items are rated on a 5-point Likert scale (1, not at all fearful; 5, extremely fearful). Mean scores will be calculated to generate average fear per participant, with higher scores indicating higher levels of fear.
Self-efficacy related to colonoscopy
Time Frame: Up to 12 months post-abnormal FIT result
Intervention arm patients will complete a pre- and post-intervention survey that will include questions about self-efficacy related to a colonoscopy. Usual care patients will complete a baseline survey on the same measures. Self-efficacy will be assessed by adopting an 8-item self-efficacy scale for colonoscopy completion in patients with inflammatory bowel diseases and responses will be recorded on a 5-point scale. Higher scores will indicate higher levels of self-efficacy.
Feasibility: number of contacts needed to reach target enrollment
Time Frame: Up to 12 months post-abnormal FIT result
Feasibility will be measured by recruitment as the number of contacts required to reach target enrollment.
Feasibility: time to reach recruitment
Time Frame: Up to 12 months post-abnormal FIT result
Feasibility will be measured by recruitment as the time required to reach target enrollment. Time to reach recruitment target will be measured in days and described using medians and interquartile range (IQR).
Acceptability of the video intervention assessed by a survey
Time Frame: Up to 12 months post-abnormal FIT result
Intervention arm patients will complete a post-intervention survey to assess acceptability of the intervention using the Acceptability of Intervention Measure (AIM), a 4-item measure. Items are rated on a 5-point Likert Scale (1, completely disagree; 5, completely agree). Mean scores will be calculated to generate an average AIM score, where higher scores will indicate higher levels of acceptability.
Knowledge about colonoscopy
Time Frame: Up to 12 months post-abnormal FIT result
Intervention arm patients will complete a pre- and post-intervention survey that will include questions about knowledge about colon cancer screening. Usual care patients will complete a baseline survey on the same measures. Knowledge will be measured using 8 validated questions. Incorrect answers will be scored as 0 and correct answers scored as 1. Higher scores will indicate higher levels of knowledge.
Intent to complete a colonoscopy
Time Frame: Up to 12 months post-abnormal FIT result
Intervention arm patients will complete a pre- and post-intervention survey that will include questions about intent to complete a colonoscopy. Usual care patients will complete a baseline survey on the same measures. Intent will be measured using a single validated question on a nominal scale with 5 options. Responses will be dichotomized to affirmative intent (definitely will do, will do) or uncertain intent (don't know, will not do, and definitely will not do).
Secondary Outcomes
- Incidence of completed colonoscopies(At 6 months post randomization)