Effectiveness and implementation of mPATH™-CRC: a mobile health system for colorectal cancer screening.

Adult Humans Early Detection of Cancer / methods Colorectal Neoplasms / diagnosis Mass Screening / methods Government Programs Colonoscopy
Colorectal cancer Implementation Mobile health Screening

Journal

Trials
ISSN: 1745-6215
Titre abrégé: Trials
Pays: England
ID NLM: 101263253

Informations de publication

Date de publication:
14 Apr 2023
Historique:
received: 13 03 2023
accepted: 23 03 2023
medline: 18 4 2023
entrez: 14 4 2023
pubmed: 15 4 2023
Statut: epublish

Résumé

Screening for colorectal cancer (CRC) is widely recommended but underused, even though CRC is the third most diagnosed cancer and the second leading cause of cancer death in the USA. The mPATH™ program is an iPad-based application designed to identify patients due for CRC screening, educate them on the commonly used screening tests, and help them select their best option, with the goal of increasing CRC screening rates. The mPATH™ program consists of questions asked of all adult patients at check-in (mPATH™-CheckIn), as well as a module specific for patients due for CRC screening (mPATH™-CRC). In this study, the mPATH™ program is evaluated through a Type III hybrid implementation-effectiveness design. Specifically, the study consists of three parts: (1) a cluster-randomized controlled trial of primary care clinics comparing a "high touch" evidence-based implementation strategy with a "low touch" implementation strategy; (2) a nested pragmatic study evaluating the effectiveness of mPATH-CRC™ on completion of CRC screening; and (3) a mixed-methods study evaluating factors that facilitate or impede the maintenance of interventions like mPATH-CRC™. The primary objective is to compare the proportion of patients aged 50-74 who are eligible for CRC screening who complete mPATH™-CRC in the 6th month following implementation between the "high touch" and "low touch" implementation strategies. Effectiveness of mPATH™-CRC is evaluated by comparing the proportion who complete CRC screening within 16 weeks of their visit to the clinic between a pre-implementation cohort (8 months before implementation) and a post-implementation cohort (8 months after implementation). This study will provide data on both the implementation of the mPATH™ program and its effectiveness in improving screening rates for CRC. In addition, this work has the potential to have an even broader impact by identifying strategies to support the sustained use of other similar technology-based primary care interventions. ClinicalTrials.gov NCT03843957. Registered on 18 February 2019.

Sections du résumé

BACKGROUND BACKGROUND
Screening for colorectal cancer (CRC) is widely recommended but underused, even though CRC is the third most diagnosed cancer and the second leading cause of cancer death in the USA. The mPATH™ program is an iPad-based application designed to identify patients due for CRC screening, educate them on the commonly used screening tests, and help them select their best option, with the goal of increasing CRC screening rates.
METHODS METHODS
The mPATH™ program consists of questions asked of all adult patients at check-in (mPATH™-CheckIn), as well as a module specific for patients due for CRC screening (mPATH™-CRC). In this study, the mPATH™ program is evaluated through a Type III hybrid implementation-effectiveness design. Specifically, the study consists of three parts: (1) a cluster-randomized controlled trial of primary care clinics comparing a "high touch" evidence-based implementation strategy with a "low touch" implementation strategy; (2) a nested pragmatic study evaluating the effectiveness of mPATH-CRC™ on completion of CRC screening; and (3) a mixed-methods study evaluating factors that facilitate or impede the maintenance of interventions like mPATH-CRC™. The primary objective is to compare the proportion of patients aged 50-74 who are eligible for CRC screening who complete mPATH™-CRC in the 6th month following implementation between the "high touch" and "low touch" implementation strategies. Effectiveness of mPATH™-CRC is evaluated by comparing the proportion who complete CRC screening within 16 weeks of their visit to the clinic between a pre-implementation cohort (8 months before implementation) and a post-implementation cohort (8 months after implementation).
DISCUSSION CONCLUSIONS
This study will provide data on both the implementation of the mPATH™ program and its effectiveness in improving screening rates for CRC. In addition, this work has the potential to have an even broader impact by identifying strategies to support the sustained use of other similar technology-based primary care interventions.
TRIAL REGISTRATION BACKGROUND
ClinicalTrials.gov NCT03843957. Registered on 18 February 2019.

Identifiants

DOI: 10.1186/s13063-023-07273-5 PMID: 37060023 PMC: PMC10103028
pubmed: 37060023
doi: 10.1186/s13063-023-07273-5
pii: 10.1186/s13063-023-07273-5
pmc: PMC10103028
doi:

Banques de données

ClinicalTrials.gov
['NCT03843957']

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

274

Subventions

Organisme : NCI NIH HHS
ID : R01CA218416
Pays : United States

Informations de copyright

© 2023. The Author(s).

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Auteurs

Anna C Snavely (AC)

Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA. asnavely@wakehealth.edu.
ORCID: 0000-0001-6916-4255

Kristie Foley (K)

Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Ajay Dharod (A)

Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

Mark Dignan (M)

Department of Internal Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA.

Holly Brower (H)

Wake Forest University School of Business, Winston-Salem, NC, USA.

Elena Wright (E)

Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

David P Miller (DP)

Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.

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