Introduction
colorectal cancer, early-stage disease, cancers
COLORECTAL CANCER, CANCERS
Adherence to guideline-based screening for breast, cervical, and colorectal cancer decreases mortality; unfortunately, rural screening rates fall short of Healthy People 2030 goals.Over the past 2 decades, interventions to improve screening have demonstrated efficacy for tailored messaging delivered through print, telephone, and technology.To our knowledge, no interventions have been tested to simultaneously increase the guideline-recommended breast, cervical, and colorectal cancer screenings for women. Each of these screenings can detect early-stage disease, protecting women from breast, cervical, or colorectal cancer mortality, and addressing all 3 cancers simultaneously increases the probability that women will have knowledge of and consider all screenings for which they are not up to date.This study evaluated the effect of 2 interventions: (1) a mailed, interactive digital video disc (DVD) with messages tailored to each woman’s responses and (2) the DVD followed by telephonic patient navigation (DVD/PN). Both interventions were tailored to the unique barriers, needs, and experiences of rural women by using platforms that could be delivered remotely, thereby reducing access barriers. Intervention groups were compared with usual care for increasing the percentage of women who were up to date with all recommended screening tests (breast, cervical, or colorectal). Secondary research questions tested the comparative effectiveness of the 2 interventions vs usual care for increasing the percentage of women up to date with screening for any needed screening (breast, cervical, and colorectal cancer). In addition, we assessed the costs and cost-effectiveness of these interventions.