ColoRectal Cancer Clinical Trial
Official title:
PROSPR Project 2: Comparative Effectiveness of FIT, Colonoscopy, & Usual Care Screening Strategies
The overall goal of the Parkland-UT Southwestern Population-based Research Optimizing
Screening through Personalized Regimens (PROSPR) is to optimize colon cancer screening
through personalized regimens in our integrated safety-net clinical provider network, which
serves a large and diverse population of under- and un-insured patients in Dallas.
Together, three research projects will assess clinic, system, and organizational factors
associated with over-, under- and guideline-based screening among this important population
and will compare benefits, harms, and costs of strategies for facilitating optimized
screening regimens. Our theme of optimizing colorectal cancer screening in a safety-net
clinical provider network brings together several components. Its focus on colorectal cancer
(CRC) screening which is important, because CRC is the second cancer killer in the US while
being the only major cancer for which optimized screening results in primary prevention.
Despite this strong potential benefit, CRC screening remains suboptimal overall, and
especially among low-income and minority individuals served by safety-nets. Safety-net
networks therefore offer tremendous potential for CRC prevention and control, but numerous
factors at the clinics-, system-, and organization-level influence their ability to provide
optimized care.
Each of our Parkland-UT Southwestern Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) Center's projects is innovative and addresses the continuum of care. Project 1 addresses transitions 1 and 3, employing novel, algorithmically driven tools in clinics to determine personalized optimized screening regimens for individual patients and track whether each has received the indicated guideline-based screening. Project 2 addresses all three transitions through a novel comparative effectiveness study of benefits, risks, and costs of two outreach strategies for promoting screening completion and guideline-appropriate follow-up. Project 3 addresses transitions 2 and 3 by focusing on organizational culture, structure, and protocols, using both quantitative and qualitative methods to elucidate factors influencing completion of effective screening processes. Our projects address research priorities identified through a recent National Institute of Health (NIH) State of the Science Conference, including: implementing interventions proven effective at increasing colorectal cancer (CRC) screening (Projects 1 & 2), conducting research to assess effectiveness of tailoring programs to match characteristics and preferences of target populations (Project 1), implementing systems to ensure follow up of positive CRC screening results (Projects 1, 2 & 3), and conducting studies to determine comparative effectiveness of CRC screening methods in usual practice (Project 2). ;
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