Blumenthal 2010.
| Methods |
Study design: cluster RCT Sampling frame: African Americans over age 49, no history of colorectal cancer (CRC), and no previous CRC screening within the recommended time interval Sampling method: random Collection method: telephone interview Description of the community coalition: The Community Coalition Board of the Morehouse School of Medicine Preventive Research Center comprised representatives from the medical school, 2 other academic institutions, and 6 local agencies (the health department, public schools, public housing authority, local community health center, area health education center, the Empowerment Zone Corporation), and from each of the 8 neighborhoods of Neighborhood Planning Unit Y of Atlanta, plus some adjoining neighborhoods. Community members held most of the positions as well as the chair. The Board served in a governance rather than advisory capacity as a senior partner with the medical school, established the research agenda for the PRC, reviewed all research protocols, and participated in study recruitment |
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| Participants |
Communities: all participants (n = 369) recruited from 4 counties of the Atlanta metropolitan area (DeKalb, Fulton, Cobb, Clayton) Country: USA Ages included in assessment: 50+ (mean age 68) Reasons provided for selection of intervention community: none stated Intervention community (population size): Atlanta metro area (not stated) Comparison community (population size): Atlanta metro area (not stated) |
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| Interventions |
Name of intervention: Colorectal Cancer Screening Intervention Trial (CCSIT) Theory: Social‐Ecologic Theory, Social Cognitive Theory Aim: to test 3 interventions to increase colorectal cancer screening rates among African Americans. These interventions also addressed gaps in the evidence as summarized in the Guide to Community Preventive Services; each approach is considered by the Guide to have "insufficient evidence" on which to base a recommendation Description of costs and resources: not reported Components of the intervention: 3‐arm trial:
Start date: January 2003 Duration: up to 4 weeks |
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| Outcomes |
Outcomes and measures: Primary: receipt of colorectal cancer screening test (self report, not defined) Secondary: CRC knowledge (7‐item questionnaire) Time points: baseline and follow‐up (3 months, 6 months) |
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| Notes | Participants were randomly assigned to intervention or control arm by recruitment site; controls received educational materials at introductory session. Participants who withdrew after randomization but before intervention were not included in the analysis. 30% of participants were lost to follow‐up and were considered unscreened Source of funding: government |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Not specified |
| Allocation concealment (selection bias) | Unclear risk | Not specified |
| Baseline outcome measurement similar | Low risk | None of the participants had been screened at baseline |
| Baseline characteristics similar | Unclear risk | Baseline characteristics of groups similar, except participants in financial support arm were more likely to have private insurance |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Blinding not reported |
| Incomplete outcome data (attrition bias) All outcomes | High risk | 40% of participants withdrew after randomization or were lost to follow‐up after intervention. Study completers tended to be better educated than non‐completers |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | No blinding |
| Protection against contamination | Unclear risk | Participants cluster‐randomized by recruitment site to minimize contamination; no information provided about relationships or social cross‐over among sites |
| Selective reporting (reporting bias) | Low risk | All relevant outcomes are reported |