Social Network Encouragement for Colon Cancer Screening

Not currently recruiting at 6 trial locations

Overseen By Jennifer Leng, MD, MPH

Age: 18+

Sex: Male

Trial Phase: Academic

Sponsor: Memorial Sloan Kettering Cancer Center

Disqualifiers: Household member participated, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to increase colorectal cancer screenings in the Black community by training participants to encourage others in their social circles to get tested. Participants will learn how to discuss FIT testing, a simple at-home test that checks for signs of cancer in stool, with friends and family. The study will compare two groups: one receiving general education about colorectal cancer and another receiving detailed support on promoting FIT testing through Peer Outreach, a social network intervention. It is suitable for Black men aged 45 to 75 who have completed FIT testing in the past year and have a network of at least five close Black male friends or relatives in the same age range. As an unphased trial, this study offers participants the opportunity to contribute to community health by promoting early cancer detection.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this peer outreach program is safe for increasing colorectal cancer screening?

Research has shown that organized programs for colorectal cancer (CRC) screening are safe and effective. These programs help people, especially in underserved communities, overcome barriers to screening. For example, the SCORE project, which focused on CRC screening outreach, found that these programs can successfully address common obstacles without causing harm.

Studies have found that these outreach efforts are generally well-received. They provide education and support to encourage screening using the fecal immunochemical test (FIT). This test checks for signs of cancer in stool samples and can be done at home.

Overall, evidence suggests that the approach used in this study, which includes peer outreach and education, is safe for participants. No reports indicate negative effects from participating in similar outreach programs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the "Social Network Encouragement for Colon Cancer Screening" trial because it explores a novel way to boost colon cancer screening rates through peer support and education. Unlike traditional methods that rely solely on direct patient outreach and medical recommendations, this trial leverages social networks to encourage individuals to get screened. By providing both colorectal cancer education and peer outreach tools, like handouts and text messages, this approach aims to create a community-driven movement for increased screening. This method could potentially improve screening rates by harnessing the power of personal relationships and social influence, which is a fresh and promising strategy in the fight against colon cancer.

What evidence suggests that this trial's peer outreach intervention could be effective for increasing colorectal cancer screening?

Research shows that peer outreach can significantly increase colorectal cancer screening rates. In this trial, participants in the "FITx3 intervention and CRC education" arm will receive education and support to promote peer outreach, which studies have shown leads to a 42% increase in cancer screenings for underserved groups, including colorectal cancer. One study discovered that mailing information and offering patient support improved screening rates by 7.3 percentage points compared to regular care. These programs educate communities and provide necessary resources. Encouraging people to share information with friends and family has also yielded promising results in boosting screenings. Meanwhile, participants in the "Colorectal Cancer (CRC) education alone" arm will receive education on CRC and screening methods. ^{1 2 6 7 8}

Who Is on the Research Team?

Francesca Gany, MD, MPH

Principal Investigator

Memorial Sloan Kettering Cancer Center

Are You a Good Fit for This Trial?

This trial is for Black men, aged 45-75, who have completed FIT testing in the past year. Participants must speak English or French fluently and have at least five close male peers over 45 years old. Men with a household member already in the study cannot join.

Inclusion Criteria

I know at least 5 Black men aged 45-75 who are close to me.

I am male.

Has completed FIT testing within the prior year

Exclusion Criteria

Has a household member who has already participated (or agreed to participate)

Has already been approached by a peer participating in the study (index participant) to complete FIT testing

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Education and Training

Participants receive education on colorectal cancer and training on peer outreach to encourage FIT testing

8 months

Monthly telephone support and biweekly text messages

Follow-up

Participants complete follow-up form and assist in completion of peer outreach tracker

8 months

What Are the Treatments Tested in This Trial?

Interventions

• Peer Outreach

Trial Overview The study tests if training individuals to encourage their peers to undergo colorectal cancer screening (FIT testing) increases screening rates. It compares outcomes of those given both peer outreach training and CRC education versus those receiving only CRC education.

How Is the Trial Designed?

Group I: FITx3 intervention and CRC education Experimental Treatment 1 Intervention

Provide CRC education, SN education, handouts and text message/social media posts example library. Monthly Telephone Support Provide any additional support to index participants for peer FIT testing, assist in completion of peer outreach tracker. Biweekly Text Messages. Follow-up Assessment (month 8 after intervention) Complete follow-up form and assist in completion of peer outreach tracker Provide reminders to encourage participants to encourage peers to get FIT tested.

Group II: Colorectal Cancer (CRC) education alone Active Control 1 Intervention

All participants will be educated, on a simplified clinical and medical background of CRC; causes and risk factors for CRC; eligibility criteria for screening; lifestyle modifications to lower risk of developing CRC; screening methods for CRC, including FIT and colonoscopy; addressing myths and misconceptions about CRC; and information about resources for low-cost and no-cost screening, screening for the uninsured and screening for those without legal immigration documentation. Participants will also be educated on elements of fecal immunochemical testing (detects signs of cancer in the stool, can be done at home and sent to a laboratory for analysis, needs to be done yearly to ensure maximal effectiveness for cancer screening). Follow-up Assessment at 8 months complete follow-up form and assist in completion of peer outreach tracker Provide reminders to encourage participants to encourage peers to get FIT tested.

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials

1,998

Recruited

602,000+

CANCER PREVENTION FUND

Collaborator

Trials

1

Recruited

80+

Published Research Related to This Trial

A review of 15 community-based randomized controlled trials found that 73% of interventions significantly increased colorectal cancer screening rates, particularly those using patient mailings and telephone outreach.

Tailoring information to patient preferences and considering community-level factors were key strategies that contributed to the success of these interventions in improving screening rates among multi-ethnic groups.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community-based colorectal cancer screening trials with multi-ethnic groups: a systematic review. Morrow, JB., Dallo, FJ., Julka, M.[2021]

A targeted intervention using social support significantly increased the completion rates of colorectal cancer screening among Latino adults, with a return rate of 66% in the social support group compared to 47.2% in the control group.

The study involved 264 Latino adults aged 50 and older, and those receiving social support were 2.67 times more likely to return a completed screening test, highlighting the importance of community-based strategies in improving screening uptake.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of Social Support on Colorectal Cancer Screening among Adult Hispanics/Latinos: A Randomized Community-based Study in Central Pennsylvania. Dominic, OG., Chinchilli, V., Wasserman, E., et al.[2021]

A study involving 387 e-mail users aged 42-73 showed that 74.4% were willing to send personalized e-mail messages to encourage colorectal cancer screening, indicating a strong potential for social support interventions.

Most participants who edited the message made changes to improve its tone and personalization without altering its meaning, suggesting that modifiable e-mail messages could effectively promote screening within social networks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

E-mail to Promote Colorectal Cancer Screening Within Social Networks: Acceptability and Content. Cutrona, SL., Wagner, J., Roblin, DW., et al.[2018]

The feasibility phase of a Facebook awareness campaign reached 39,900 people, with 9,200 engaging with the content, leading to 298 applications for colorectal cancer screening test kits, demonstrating the potential of social media to increase awareness and participation in screening programs.

The expected participation rate from the full campaign could increase significantly, with estimates suggesting that 5%-11% of tests could be completed compared to traditional methods, indicating that this approach may effectively mobilize previously unengaged individuals in colorectal cancer screening.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of encouraging participation in colorectal cancer screening campaigns by motivating people through the social network, Facebook. Koïvogui, A., Levi, S., Finkler, M., et al.[2021]

Women with larger social networks have better breast cancer survival rates and lower mortality risks, highlighting the importance of social relationships in cancer outcomes.

The review identifies various mechanisms, beyond just social support, such as social resources and norms, that could influence cancer outcomes, suggesting new avenues for interventions to improve patient care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A conceptual model of social networks and mechanisms of cancer mortality, and potential strategies to improve survival. Kroenke, CH.[2023]

Community outreach events for colorectal cancer (CRC) screening can motivate individuals to seek or obtain screening, with 26.7% of participants who were due for screening doing so within 3 months after attending an event.

However, many attendees were already compliant with screening guidelines, indicating that these events may not effectively reach those most in need of screening, particularly if priority audiences are not specifically targeted.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Results from an Evaluation of the Georgia Colorectal Cancer Control Program's Community Education and Outreach Events, 2013. Woodruff, RC., Hermstad, A., Honeycutt, S., et al.[2019]

In a study of 787 Appalachian residents, 10 key players were identified as influential figures in their communities, highlighting the importance of communication and resourcefulness in promoting colorectal cancer (CRC) screening.

Barriers to CRC screening included negative perceptions of colonoscopy and discomfort with the medical system, but key players suggested increasing awareness, providing information on screening options, and improving access as effective strategies to enhance screening rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Colorectal cancer prevention: Perspectives of key players from social networks in a low-income rural US region. Schoenberg, NE., Eddens, K., Jonas, A., et al.[2022]

The outreach program significantly increased colorectal cancer screening rates, with 45% of unscreened members completing screening after receiving an interactive voice response call and mailed fecal immunochemical test (FIT), resulting in a hazard ratio of 4.08 for screening completion.

The program was particularly effective for individuals without recent primary or specialty care visits, highlighting the need for targeted strategies to improve screening rates among underrepresented groups, such as African Americans and Hispanics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Automated phone and mail population outreach to promote colorectal cancer screening. Kempe, KL., Shetterly, SM., France, EK., et al.[2022]

The 'Friend to Friend' intervention successfully increased breast cancer screening rates among women aged 40 and older in Minneapolis public housing from 1990 to 1995, demonstrating its effectiveness in a community-based setting.

The successful adoption and adaptation of this intervention by the American Cancer Society for broader use in the state highlights the importance of collaboration between research and community organizations to enhance public health initiatives.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Incorporation of a successful community-based mammography intervention: dissemination beyond a community trial. Slater, JS., Finnegan, JR., Madigan, SD.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12306618/

Screen to Save: Results from NCI's Colorectal Cancer ... The toolkit included: 1) a one-page initiative overview; 2) an outreach plan template; 3) an educational PowerPoint presentation that NON CHEs ...

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2827032

Intervention and Outreach for Colorectal Cancer Screening The study highlights the importance of organized outreach programs for CRC screening, which removes many of the barriers faced by underserved populations.

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12153609/

Organizational Determinants, Outcomes Related to ... The intervention, targeting multiple types of cancer, reported a 42% absolute increase in cervical screening and comparable gains in breast ...

4. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2831644

Mailed Outreach and Patient Navigation for Colorectal ... A mailed FIT outreach and patient navigation program led to a significant 7.3–percentage point increase in colorectal cancer (CRC) screening over usual care.

5. cdc.gov cdc.gov/pcd/issues/2025/25_0025.htm

Interventions to Increase Colorectal Cancer Screening ... We performed a scoping review to describe the types and effectiveness of interventions to increase CRC screening in primarily rural settings.

6. sciencedirect.com sciencedirect.com/science/article/pii/S2211335523002449

Barriers and facilitators of colorectal cancer screening ... A total of 1659 abstracts were screened against inclusion and exclusion criteria within the Covidence Review platform, and 1364 studies were deemed irrelevant.

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8499575/

Centralized colorectal cancer screening outreach and patient ... The Scaling Colorectal Cancer Screening Through Outreach, Referral, and Engagement (SCORE) project is designed to address barriers to CRC screening in ...

8. gastrojournal.org gastrojournal.org/article/S0016-5085(24)05302-2/fulltext

Interventions to Increase Follow-Up of Abnormal Stool ... Interventions to increase follow-up of abnormal stool-based colorectal cancer screening tests in safety net settings: a systematic review.