Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_2DB3AF6645F9
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Impact of a health literacy intervention combining general practitioner training and a consumer facing intervention to improve colorectal cancer screening in underserved areas: protocol for a multicentric cluster randomized controlled trial.
Journal
BMC public health
Author(s)
Durand M.A., Lamouroux A., Redmond N.M., Rotily M., Bourmaud A., Schott A.M., Auger-Aubin I., Frachon A., Exbrayat C., Balamou C., Gimenez L., Grosclaude P., Moumjid N., Haesebaert J., Massy H.D., Bardes J., Touzani R., Diant LBEF, Casanova C., Seitz J.F., Mancini J., Delpierre C.
ISSN
1471-2458 (Electronic)
ISSN-L
1471-2458
Publication state
Published
Issued date
16/09/2021
Peer-reviewed
Oui
Volume
21
Number
1
Pages
1684
Language
english
Notes
Publication types: Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Abstract
Colorectal cancer (CRC) is a leading cause of cancer burden worldwide. In France, it is the second most common cause of cancer death after lung cancer. Systematic uptake of CRC screening can improve survival rates. However, people with limited health literacy (HL) and lower socioeconomic position rarely participate. Our aim is to assess the impact of an intervention combining HL and CRC screening training for general practitioners (GPs) with a pictorial brochure and video targeting eligible patients, to increase CRC screening and other secondary outcomes, after 1 year, in several underserved geographic areas in France.
We will use a two-arm multicentric randomized controlled cluster trial with 32 GPs primarily serving underserved populations across four regions in France with 1024 patients recruited. GPs practicing in underserved areas (identified using the European Deprivation Index) will be block-randomized to: 1) a combined intervention (HL and CRC training + brochure and video for eligible patients), or 2) usual care. Patients will be included if they are between 50 and 74 years old, eligible for CRC screening, and present to recruited GPs. The primary outcome is CRC screening uptake after 1 year. Secondary outcomes include increasing knowledge and patient activation. After trial recruitment, we will conduct semi-structured interviews with up to 24 GPs (up to 8 in each region) and up to 48 patients (6 to 12 per region) based on data saturation. We will explore strategies that promote the intervention's sustained use and rapid implementation using Normalization Process Theory. We will follow a community-based participatory research approach throughout the trial. For the analyses, we will adopt a regression framework for all quantitative data. We will also use exploratory mediation analyses. We will analyze all qualitative data using a framework analysis guided by Normalization Process Theory.
Limited HL and its impact on the general population is a growing public health and policy challenge worldwide. It has received limited attention in France. A combined HL intervention could reduce disparities in CRC screening, increase screening rates among the most vulnerable populations, and increase knowledge and activation (beneficial in the context of repeated screening).
Registry: ClinicalTrials.gov.
2020-A01687-32 . Date of registration: 17th November 2020.
Keywords
Aged, Colorectal Neoplasms/diagnosis, Early Detection of Cancer, General Practitioners, Health Literacy, Humans, Medically Underserved Area, Middle Aged, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Colorectal cancer screening, General practitioner training, health disparities, Health literacy, Intervention
Pubmed
Web of science
Open Access
Yes
Create date
27/09/2021 10:53
Last modification date
08/08/2024 6:31
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