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FOBT Completion in FQHCs: Impact of Physician Recommendation, FOBT Information, or Receipt of the FOBT Kit
Author(s) -
Davis Terry C.,
Arnold Connie L.,
Rademaker Alfred W.,
Platt Daci J.,
Esparza Julia,
Liu Dachao,
Wolf Michael S.
Publication year - 2012
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/j.1748-0361.2011.00402.x
Subject(s) - medicine , fecal occult blood , family medicine , psychological intervention , receipt , primary care , colorectal cancer , cancer , colonoscopy , nursing , world wide web , computer science
Abstract Purpose: To determine the effect of common components of primary care‐based colorectal cancer (CRC) screening interventions on fecal occult blood test (FOBT) completion within rural and urban community clinics, including: (1) physician's spoken recommendation, (2) providing information or education about FOBTs, and (3) physician providing the FOBT kit; to determine the relative effect of these interventions; and to compare the effect of each intervention between rural and urban clinics. Methods: We conducted structured interviews with patients aged 50 years and over receiving care at community clinics that were noncompliant with CRC screening. Self‐report of ever receiving a physician's recommendation for screening, FOBT information or education, physician providing an FOBT kit, and FOBT completion were collected. Findings: Participants included 849 screening‐eligible adults; 77% were female and 68% were African American. The median age was 57; 33% lacked a high school diploma and 51% had low literacy. In multivariable analysis, all services were predictive of rural participants completing screening (physician recommendation: P = .002; FOBT education: P = .001; physician giving FOBT kit: P < .0001). In urban clinics, only physician giving the kit predicted FOBT completion ( P < .0001). Compared to urban patients, rural patients showed a stronger relationship between FOBT completion and receiving a physician recommendation (risk ratio [RR]: 5.3 vs 2.1; P = .0001), receiving information or education on FOBTs (RR: 3.8 vs 1.9; P = .0002), or receiving an FOBT kit from their physician (RR: 22.3 vs 10.1; P = .035). Conclusions: Participants who receive an FOBT kit from their physician are more likely to complete screening.