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Reasons for non-response to a direct-mailed FIT kit program: lessons learned from a pragmatic colorectal-cancer screening study in a federally sponsored health center

  • Original Research
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Translational Behavioral Medicine

Abstract

Colorectal cancer screening rates are below optimal. As part of a pilot clinic-based pragmatic study aiming to raise rates of colorectal-cancer screening, we explored patients’ reasons for not responding to a direct-mailed screening invitation. We conducted telephone interviews with patients who were mailed a fecal immunochemical test (FIT) but who did not return it to the lab. Interviews were audio-recorded, transcribed, and coded for thematic analysis. We met our goal of 20 interviews (10 in English and 10 Spanish; 75 % female). Reasons for not completing tests were fear of results or cost of follow-up colonoscopy (n = 9); not having received the test in the mail (n = 7); concerns about mailing fecal matter or that test results could be mixed up (n = 6); and being busy or forgetful (n = 4). Efforts to improve uptake of colorectal cancer screening in a direct-mailed program ought to address concerns identified in our study.

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Acknowledgments

The authors would like to acknowledge technical assistance provided by Leslie Bienen, DVM, MFA, and Christine Wilkins.

Human subjects statement

I confirm all patient/personal identifiers have been removed or disguised so the patient/person(s) described are not identifiable and cannot be identified through the details of the story.

Sources of funding

Research reported in this publication was supported by the National Center for Complementary and Alternative Medicine of the National Institutes of Health under Award Number UH2AT007782. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Conflicts of interest

The authors have declared that they have no conflicts of interest.

Clinical Trials Registration Number

NCT01742065

Author information

Authors and Affiliations

  1. Kaiser Permanente Center for Health Research, 3800 N. Interstate Ave., Portland, OR, 97227, USA

    Gloria D Coronado PhD, Jennifer L Schneider MPH, Jennifer J Sanchez MA & Amanda F Petrik MS

  2. Group Health Research Institute, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA

    Beverly Green MD, MPH

Authors
  1. Gloria D Coronado PhD
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  2. Jennifer L Schneider MPH
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  3. Jennifer J Sanchez MA
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  4. Amanda F Petrik MS
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  5. Beverly Green MD, MPH
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Corresponding author

Correspondence to Gloria D Coronado PhD.

Additional information

Implications

Practice: Health care providers ought to be aware of the barriers faced by patients in returning direct-mailed FIT tests.

Policy: Efforts to assure affordable low-cost colonoscopy are needed to allay patient fears about FIT testing.

Research: Further research is warranted to inform effective patient-centered strategies to encourage participation in colorectal cancer screening programs.

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Coronado, G.D., Schneider, J.L., Sanchez, J.J. et al. Reasons for non-response to a direct-mailed FIT kit program: lessons learned from a pragmatic colorectal-cancer screening study in a federally sponsored health center. Behav. Med. Pract. Policy Res. 5, 60–67 (2015). https://doi.org/10.1007/s13142-014-0276-x

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  • DOI: https://doi.org/10.1007/s13142-014-0276-x

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