A randomized controlled trial of a multilevel intervention to increase colorectal cancer screening among Latino immigrants in a primary care facility

J Gen Intern Med. 2010 Jun;25(6):564-7. doi: 10.1007/s11606-010-1266-4. Epub 2010 Mar 6.


Background: Latino immigrants face a higher burden of colorectal cancer (CRC) and screening rates are low.

Objective: To assess the effectiveness of a multilevel intervention in increasing the rate of CRC screening among Latino immigrants.

Design: A randomized controlled trial, with randomization at the physician level.

Participants: Pairs of 65 primary care physicians and 65 Latino immigrant patients participated, 31 in the intervention and 34 in the control group.

Intervention: CRC educational video in Spanish on a portable personal digital video display device accompanied by a brochure with key information for the patient, and a patient-delivered paper-based reminder for their physician.

Measurements: Completed CRC screening, physician recommendation for CRC screening, and patient adherence to physician recommended CRC screening.

Results: The overall rate of completed screening for CRC was 55% for the intervention and 18% for the control group (p = 0.002). Physicians recommended CRC screening for 61% of patients in the intervention group versus 41% in the control group (p = 0.08). Of those that received a recommendation, 90% in the intervention group adhered to it versus 26% in the control group (p = 0.007).

Conclusions: The intervention was successful in increasing rates of completed CRC screening primarily through increasing adherence after screening was recommended. Additional efforts should focus on developing new strategies to increase physician recommendation for CRC screening, while employing effective patient adherence interventions.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Colorectal Neoplasms / diagnosis*
  • Cultural Competency
  • Early Detection of Cancer*
  • Emigrants and Immigrants
  • Female
  • Hispanic or Latino
  • Humans
  • Male
  • Mass Screening*
  • Middle Aged
  • Patient Education as Topic
  • Primary Health Care
  • Urban Population