Background:Achieving adequate response rates and participation in primary care-based intervention studies to increase colorectal cancer screening (CRCS) adherence is challenging. This study evaluates various response-inducing strategies to increase response and differences by site in an ongoing multi-site trial.

Methods: Using electronic health records to identify patients who are non-adherent to CRCS recommendations, to date, we contacted 2722 adults, age 50-75 years, in a relatively affluent Virginia population and historically under-served Pennsylvania population. Using a modified Dillman method with an unconditional incentive and nominal conditional incentive, across 24 bi-weekly waves of data collection, each site received various methods for recruitment including mail-only, e-mail + portal message, mail + portal message as well as mail-only waves (5 Virginia, 6 Pennsylvania) randomized to mail with a lottery with a chance to “win” an additional larger incentive or mail without the lottery incentive.

Results: The overall response rate was 42% (male=16%, female=22%; p<0.05); 53% of responders were study-eligible. Mailed recruitment was more effective than e-mail or patient portal recruitment. In Virginia, those randomized to an increased lottery incentive were not more likely to participate compared to those without lottery incentive (43% vs. 50%; p >0.05). Conversely, in Pennsylvania, the lottery incentive yielded higher response rates compared to no lottery incentive (53% vs. 40%; p<0.05).

Conclusion: Lottery recruitment strategies with a chance to “win” a larger incentive are statistically effective in populations with relatively low socioeconomic status whereas the strategy does not appear to be effective in affluent populations.

Most breast cancers in Oman are diagnosed at advanced stages and therefore early detection is important. The Oman Cancer Association (OCA) initiated a mobile mammography program in 2009, but no studies have evaluated its impact. This study aimed at estimating the proportion and predictors of OCA-screened women who had repeated mammography (compliance) and the sensitivity and specificity of the program.

Demographic, screening, diagnosis, and treatment data of 13,079 women screened in the OCA mammography clinic from 2009-2016, and medical records of all breast cancer patients seen at Royal and Sultan Qaboos University hospitals during the same period were retrieved.. Logistic regression analysis was conducted to identify predictors of compliance.

A total of 8,278 screened women over age 42 years (median age of 50±8 years) were in the study). Only 18% of initially negative screened women were compliant with recommended subsequent screening. Predictors of compliance included age (50-69) years, family history of cancer, family history of breast cancer, and breast self-examination. The cancer detection rate was 4.1/1000 screened women. Positive predictive value of screening was 4.7% with a sensitivity rate of 53% and specificity of 92%.

This study showed a low mammography compliance rate among previously screened women. The study revealed low sensitivity, high specificity, and an acceptable cancer detection rate. Future programs should focus on improving data collection of screened women, maintaining the linkage of databases between breast cancer screening and treatment clinics, and developing guidelines and policies for breast cancer screening in Oman and other similar populations.

Background: Given the pervasiveness and costliness of cancer, it is critical to implement effective prevention strategies informed by the best available research evidence. Despite expectations for evidence-informed decision making in public health, challenges exist. The objectives of this study were to test the effectiveness of three dissemination and implementation (D&I) interventions for enhancing awareness and use of high-quality cancer prevention evidence among Canadian public health professionals.

Methods: A prospective cohort before and after study tested three D&I interventions (i.e., monthly tailored email messages (TMs), quarterly webinars, and weekly Twitter^TM posts) to disseminate high-quality systematic review findings on cancer prevention over 18 months. Data was collected via an electronic survey at baseline (Fall 2015) and follow-up (Spring-Fall 2017) on awareness and use of systematic review evidence in cancer prevention decision-making, and satisfaction with D&I interventions.

Findings: 313 participants enrolled in the study and 134 participants (42.9%) completed follow-up. Higher satisfaction scores were reported for TMs (M = 31.6, SD = 8.1) and webinars (M = 31.4, SD = 7.7), compared to Twitter^TM (M = 24.9, SD = 8.2). Greater satisfaction was reported for increasing awareness of high-quality research evidence, as compared to promoting its use in practice. No significant increases in awareness and use of research evidence were found from baseline to follow-up across all interventions.

Implications for D&I Research: When considering social media as a D&I intervention, Twitter^TM may not be optimal, given greater satisfaction with other interventions and the specialized resources needed to summarize research evidence within technological constraints.

Background. The Centers for Medicare & Medicaid Services approved coverage of low-dose CT screening for lung cancer in 2015, but screening rates have remained low. In 2018, a large urban health system formed a learning community to increase screening in populations that have high smoking rates.

Methods. The 90-member Lung Cancer Learning Community is comprised of a Coordinating Team (health system personnel), Steering Committee (health system administrators, payer representatives, and community organization leaders), and Patient and Stakeholder Advisory Committee (health system patients, providers, screening program staff). Learning community members assessed lung cancer screening in the health system, identified screening barriers and facilitators, and developed an outreach strategy to optimize population lung cancer screening rates.

Results: We determined that lung cancer screening rates are low (< 5%) among white and nonwhite health system primary care patients. In addition, the learning community developed low-literacy multi-lingual patient lung cancer screening print education materials, revised an existing lung cancer screening decision aid, and adapted an online software application for use in outreach contacts. The learning community also identified 3,000 primary care patients who are eligible for lung cancer screening. The health system will implement the tools described here and will compare the impact of centralized outreach contacts to usual care on lung cancer screening.

Conclusions: The learning community has developed a combined intervention strategy that targets primary care patients eligible for lung cancer. Findings from the planned intervention project will help to shape health system efforts to increase lung cancer screening rates.