Research and Publications - Department of Health Science

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Browsing Research and Publications - Department of Health Science by Subject "1ST-DEGREE RELATIVES"

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    Examining the challenges of family recruitment to behavioral intervention trials: factors associated with participation and enrollment in a multi-state colonoscopy intervention trial
    (BMC, 2013) Simmons, Rebecca G.; Lee, Yuan-Chin Amy; Stroup, Antoinette M.; Edwards, Sandra L.; Rogers, Amy; Johnson, Christopher; Wiggins, Charles L.; Hill, Deirdre A.; Cress, Rosemary D.; Lowery, Jan; Walters, Scott T.; Jasperson, Kory; Higginbotham, John C.; Williams, Marc S.; Burt, Randall W.; Schwartz, Marc D.; Kinney, Anita Y.; Huntsman Cancer Institute; University of Utah; University of New Mexico; University of Colorado Anschutz Medical Campus; University of Alabama Tuscaloosa; Georgetown University
    Background: Colonoscopy is one of the most effective methods of cancer prevention and detection, particularly for individuals with familial risk. Recruitment of family members to behavioral intervention trials remains uniquely challenging, owing to the intensive process required to identify and contact them. Recruiting at-risk family members involves contacting the original cancer cases and asking them to provide information about their at-risk relatives, who must then be contacted for study enrollment. Though this recruitment strategy is common in family trials, few studies have compared influences of patient and relative participation to nonparticipation. Furthermore, although use of cancer registries to identify initial cases has increased, to our knowledge no study has examined the relationship between registries and family recruitment outcomes. Methods: This study assessed predictors of case participation and relative enrollment in a recruitment process that utilized state cancer registries. Participation characteristics were analyzed with separate multivariable logistic regressions in three stages: (1) cancer registry-contacted colorectal cancer (CRC) cases who agreed to study contact; (2) study-contacted CRC cases who provided at-risk relative information; and (3) at-risk relatives contacted for intervention participation. Results: Cancer registry source was predictive of participation for both CRC cases and relatives, though relative associations (odds ratios) varied across registries. Cases were less likely to participate if they were Hispanic or nonwhite, and were more likely to participate if they were female or younger than 50 at cancer diagnosis. At-risk relatives were more likely to participate if they were from Utah, if another family member was also participating in the study, or if they had previously had a colonoscopy. The number of eligible cases who had to be contacted to enroll one eligible relative varied widely by registry, from 7 to 81. Conclusions: Family recruitment utilizing cancer registry-identified cancer cases is feasible, but highly dependent on both the strategies and protocols of those who are recruiting and on participant characteristics such as sex, race, or geography. Devising comprehensive recruitment protocols that specifically target those less likely to enroll may help future research meet recruitment goals.
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    Telehealth Personalized Cancer Risk Communication to Motivate Colonoscopy in Relatives of Patients With Colorectal Cancer: The Family CARE Randomized Controlled Trial
    (American Society of Clinical Oncology, 2014) Kinney, Anita Y.; Boonyasiriwat, Watcharaporn; Walters, Scott T.; Pappas, Lisa M.; Stroup, Antoinette M.; Schwartz, Marc D.; Edwards, Sandra L.; Rogers, Amy; Kohlmann, Wendy K.; Boucher, Kenneth M.; Vernon, Sally W.; Simmons, Rebecca G.; Lowery, Jan T.; Flores, Kristina; Wiggins, Charles L.; Hill, Deirdre A.; Burt, Randall W.; Williams, Marc S.; Higginbotham, John C.; University of Utah; Huntsman Cancer Institute; Intermountain Healthcare; Intermountain Medical Center; Chulalongkorn University; University of North Texas Health Science Center; University of Texas Health Science Center Houston; University of Texas School Public Health; Georgetown University; Colorado School of Public Health; University of Colorado Denver; University of New Mexico; Geisinger Health System; University of Alabama Tuscaloosa
    Purpose The rate of adherence to regular colonoscopy screening in individuals at increased familial risk of colorectal cancer (CRC) is suboptimal, especially among rural and other geographically underserved populations. Remote interventions may overcome geographic and system-level barriers. We compared the efficacy of a telehealth-based personalized risk assessment and communication intervention with a mailed educational brochure for improving colonoscopy screening among at-risk relatives of patients with CRC. Methods Eligible individuals age 30 to 74 years who were not up-to-date with risk-appropriate screening and were not candidates for genetic testing were recruited after contacting patients with CRC or their next of kin in five states. Enrollees were randomly assigned as family units to either an active, personalized intervention that incorporated evidence-based risk communication and behavior change techniques, or a mailed educational brochure. The primary outcome was medically verified colonoscopy within 9 months of the intervention. Results Of the 481 eligible and randomly assigned at-risk relatives, 79.8% completed the outcome assessments within 9 months; 35.4% of those in the personalized intervention group and 15.7% of those in the comparison group obtained a colonoscopy. In an intent-to-treat analysis, the telehealth group was almost three times as likely to get screened as the low-intensity comparison group (odds ratio, 2.83; 95% CI, 1.87 to 4.28; P < .001). Persons residing in rural areas and those with lower incomes benefitted at the same level as did urban residents. Conclusion Remote personalized interventions that consider family history and incorporate evidence-based risk communication and behavior change strategies may promote risk-appropriate screening in close relatives of patients with CRC.