Promoting Colorectal Cancer Screening in Rural Emergency Departments

This trial will compare the effects of a culturally targeted intervention designed to assist participants to identify and overcome individual barriers to colorectal cancer (CRC) and to promote CRC screenings using motivational interviewing (Ml) delivered by a lay health advisor (LHA) compared to the current standard-of-care (distribution of a brochure describing CRC screening services offered by the hospital) on CRC screening compliance.

The specific aim of this project is to adapt and pilot a tailored intervention to promote CRC screenings in a rural Appalachian Kentucky emergency department (ED) in order to: (a) evaluate the feasibility of providing a cancer screening promotion intervention in an emergency department (ED) that serves a rural Appalachian community; and (b) assess the effects of the intervention on barriers to CRC screening, stage of readiness to screen and CRC screening engagement. The first phase of the project will involve the adaptation and pretesting of the intervention. This phase will take approximately 6 months. The second phase of the project will involve piloting the intervention and evaluating its efficacy and feasibility and will take place over the following 18 months. We will conduct a randomized controlled trial to examine the efficacy and feasibility of delivering the LHA delivered MI intervention to promote CRC screening in persons waiting in a rural Appalachian emergency department (ED) for non urgent complaints. We will evaluate efficacy by measurement of CRC screening status at baseline and three and six months post intervention.

Subjects will engage in a brief motivational interview to establish an action plan and discuss follow-up interviews a 3 and 6 months post ED visit

Subjects will be provided a standard of care colorectal cancer screening brochure at the time of ED visit

A lay health advisor will engage the subject in a motivational interview to promote the importance of colorectal cancer screening

A lay health advisor will provide the subject with a brochure promoting the importance of colorectal cancer screening

Number of participants that seek out colorectal cancer screening after a motivational interview with a lay health advisor compared to standard of care (being provided a screening brochure)

Inclusion Criteria: 50+ years of age Rural Appalachian resident No personal history of colorectal cancer No cognitive impairment Ability to speak and understand English Has not had one of the following colorectal cancer screening tests-- Fecal Occult Blood Test within the past year Flexible sigmoidoscopy within the past five years, or Colonoscopy within the past ten years Exclusion Criteria: -