Welcome to CDC stacks |
Stacks Logo
Advanced Search
Select up to three search categories and corresponding keywords using the fields to the right. Refer to the Help section for more detailed instructions.
Clear All Simple Search
Advanced Search
Comparative effectiveness of mailed reminders with and without fecal immunochemical tests for Medicaid beneficiaries at a large county health department: A randomized controlled trial
Filetype[PDF-276.31 KB]

  • Alternative Title:
  • Description:
    Background: Colorectal cancer (CRC) screening is effective but underutilized. Screening rates among Medicaid beneficiaries are lower than for other insured populations. No studies have examined a mailed fecal immunochemical testing (FIT)-based outreach programs for Medicaid beneficiaries. Methods: We conducted a patient-level randomized controlled trial comparing a mailed CRC screening reminder with and without a FIT from an urban health department to Medicaid beneficiaries. The Reminder Group could request a FIT. Completed FITs were processed by the health department lab. Respondents were notified of normal results by mail. Abnormal results were given via phone from a patient navigator who provided counselling and assistance with follow-up care. The primary outcome was FIT return. Results: We identified 2,144 beneficiaries at average CRC risk and no evidence of screening using Medicaid claims data. We randomized 1,071 to the Reminder+FIT Group and 1,073 to the Reminder Group, of whom 307 (28.7%) in the Reminder+FIT Group and 347 (32.3%) in the Reminder Group were unreachable or ineligible (previous screening). FIT return was significantly higher in the Reminder+FIT Group than the Reminder Group (21.1% vs 12.3%; difference 8.8%; 95% CI 3.7%, 13.9%; p<0.01). Eighteen (7.2%) individuals who completed FIT tests had abnormal results, and 15 were eligible for follow-up colonoscopy; 66.7% (10) completed a follow-up colonoscopy. Conclusions: A health department-based mailed FIT program targeting Medicaid beneficiaries was feasible. Including a FIT kit resulted in greater screening completion than a reminder letter alone. Further research is needed to understand comparative cost-effectiveness of these interventions.
  • Subject:
  • Pubmed ID:
  • Pubmed Central ID:
  • Document Type:
  • Collection(s):
  • Main Document Checksum:
No Related Documents.
You May Also Like: