Journal of General Internal Medicine

, Volume 25, Issue 6, pp 564–567 | Cite as

A Randomized Controlled Trial of a Multilevel Intervention to Increase Colorectal Cancer Screening among Latino Immigrants in a Primary Care Facility

  • Abraham Aragones
  • Mark D. Schwartz
  • Nirav R. Shah
  • Francesca M. Gany
Original Article



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


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


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


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


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.


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


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).


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.


colorectal cancer immigrant health primary care prevention intervention 



This work was done in collaboration with the National Alliance for Hispanic Health. This work was supported by Cooperative Agreement Number T01 CD000146 from Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.

Conflict of Interest

None disclosed.


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Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Abraham Aragones
    • 1
    • 2
  • Mark D. Schwartz
    • 2
  • Nirav R. Shah
    • 2
  • Francesca M. Gany
    • 2
  1. 1.Downstate Medical Center, School of Public HealthState University of New YorkBrooklynUSA
  2. 2.Division of General Internal MedicineNew York University School of MedicineNew YorkUSA

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