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Colorectal CarcinomaNCT06568016

A Clinic-wide Intervention (Primary Care-GI Connect) for Improving Rates of Colonoscopy After Abnormal Fecal Immunochemical Test Result in Patients at Federally Qualified Health Centers

A study testing Best Practice, Communication Intervention and Coordination in people with Colorectal Carcinoma, run by Jonsson Comprehensive Cancer Center at 2 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

This clinical trial evaluates a clinic-wide intervention called Primary Care-Gastrointestinal (GI) Connect for improving follow-up colonoscopy rates in patients at a Federally Qualified Health Center (FQHC) who have an abnormal fecal immunochemical test (FIT) result. Read more about this study

Who is it for?
Any ageHealthy volunteers can take part
Conditions the study is for
Colorectal Carcinoma
What is being tested?
Best Practice, Communication Intervention and Coordination
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,500 participants
Where
2 sitesUnited States
Study dates
22 Apr 2025to 31 Aug 2029
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Who may be able to join

  • 6 adult care NEVHC clinic sites

Who cannot join

None listed.

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United States2 sites, 2 recruiting
  • University of California at Los Angeles

    Los Angeles, California, 90095-1406

    Jessica J Tuan, 310-825-3181, jtuan@mednet.ucla.edu

    Folasade P May, MD, PhD

    Recruiting
  • UCLA / Jonsson Comprehensive Cancer Center

    Los Angeles, California, 90095

    Folasade P. May, 310-825-4728, fmay@mednet.ucla.edu

    Folasade P. May

    Not yet recruiting

Other trials in United States

About this study

Official title: Multilevel Intervention to Improve Follow-up Colonoscopy Rates After Abnormal FIT Results in Large FQHC

This clinical trial evaluates a clinic-wide intervention called Primary Care-Gastrointestinal (GI) Connect for improving follow-up colonoscopy rates in patients at a Federally Qualified Health Center (FQHC) who have an abnormal fecal immunochemical test (FIT) result. Colorectal cancer screening reduces colorectal cancer incidence and mortality but is underutilized.The most accessible, feasible, and common colorectal cancer screening modality for average-risk individuals in low resource settings such as FQHCs is the stool-based FIT. However, the benefit of FIT screening on colorectal cancer risk is realized only if individuals with abnormal FIT results undergo timely follow-up colonoscopy. Follow-up colonoscopy rates are low and there are many barriers to follow-up colonoscopy in safety net settings such as FQHCs. Effective interventions that are multi-component and improve care coordination are needed to improve abnormal FIT follow-up rates in FQHCs. The Primary Care-GI Connect intervention includes components that enhance care coordination, standardize the referral process, and engage both primary care and specialist physicians. This clinic-wide intervention may improve rates of follow-up colonoscopy after abnormal FIT results in patients seen at FQHCs.

Read the detailed description

PRIMARY OBJECTIVES:

  1. Conduct a pragmatic, cluster randomized trial in 6 clinics (1500 patients) within a multi-site FQHC system to compare the effectiveness of the multilevel FQHC-GI care coordination intervention ("Primary Care-GI Connect "; 3 clinics, 750 patients) to the usual care condition (3 clinics, 750 patients) on receipt of a colonoscopy within 6 months of an abnormal FIT.

II. Systematically assess the quality of intervention implementation to understand the feasibility and relative importance of intervention elements as guided by the Multilevel Health Outcomes Framework.

III. Measure the incremental cost-effectiveness of the Primary Care-GI Connect intervention compared to usual care to understand the potential value, feasibility, and potential for dissemination.

OUTLINE: Northeast Valley Health Corporation (NEVHC) clinics are randomized to 1 of 2 arms.

ARM I: Patients receive clinical care consistent with current practice at NEVHC. Patients have their electronic health records (EHRs) reviewed monthly by the Primary Care FIT Tracker for abnormal FIT results and patients with abnormal FIT results receive standardized communication from FIT quality improvement (QI) champions about their results and receive a referral to gastroenterology.

ARM II: Patients receive clinical care consistent with current practice at NEVHC as described in Arm I. Patients also receive enhanced GI care coordination from GI liaisons, who generate GI FIT Tracker reports and use the GI FIT Tracker reports to follow patients with abnormal FIT results. Patients receive navigation services including contact from GI liaisons about making a GI appointment and enhanced communication between GI specialists and the NEVHC. Patients receive referral to gastroenterology following a standardized referral template and receive colonoscopy education including an informational sheet at the time of referral and a 20-minute pre-colonoscopy educational video. Patients receive a text message at the time of colonoscopy referral emphasizing the importance of colonoscopy after abnormal FIT result.

Being tested
Best Practice, Communication Intervention, Coordination, Educational Intervention, Electronic Health Record Review
Medical subject headings
Colorectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Best PracticeOther

    Also called standard of care, standard therapy

    Receive clinical care consistent with current practice

  • Communication InterventionOther

    Receive standardized communication from FIT QI champion

  • Communication InterventionOther

    Receive coordination from GI liaisons

  • CoordinationOther

    Receive enhanced GI care coordination

  • Educational InterventionOther

    Also called Education for Intervention, Intervention by Education, Intervention through Education, Intervention, Educational

    Watch pre-colonoscopy educational video

  • Electronic Health Record ReviewOther

    Undergo FIT result review by Primary Care FIT Tracker

  • Electronic Health Record ReviewOther

    Ancillary studies

  • Informational InterventionOther

    Undergo generation and review of GI FIT Tracker report

  • Informational InterventionOther

    Receive informational sheet

  • InterviewOther

    Ancillary studies

  • Patient NavigationBehavioural

    Also called Patient Navigator Program

    Receive navigation from GI liaisons

  • ReferralOther

    Also called Referred

    Receive referral

  • ReferralOther

    Also called Referred

    Receive referral per standardized template

  • Text Message-Based Navigation InterventionOther

    Also called Automated Text Message-Based Navigation, Text Message-Based Navigation

    Receive follow-up text message

Study groups in NCT06568016
Study groupRoleWhat they receive
Arm I (usual care)Active comparatorPatients receive clinical care consistent with current practice at NEVHC. Patients have their EHRs reviewed monthly by the Primary Care FIT Tracker for abnormal FIT results and patients with abnormal FIT results receive standardized communication from FIT QI champions about their results and receive a referral to gastroenterology.
Receives: Other: Best Practice; Other: Communication Intervention; Other: Electronic Health Record Review; Other: Interview; Other: Referral
Arm II (Usual care + Primary Care - GI Connect)ExperimentalPatients receive clinical care consistent with current practice at NEVHC as described in Arm I. Patients also receive enhanced GI care coordination from GI liaisons, who generate GI FIT Tracker reports and use the GI FIT Tracker reports to follow patients with abnormal FIT results. Patients receive navigation services including contact from GI liaisons about making a GI appointment and enhanced communication between GI specialists and the NEVHC. Patients receive referral to gastroenterology following a standardized referral template and receive colonoscopy education including an informational sheet at the time of referral and a 20-minute pre-colonoscopy educational video. Patients receive a text message at the time of colonoscopy referral emphasizing the importance of colonoscopy after abnormal FIT result.
Receives: Other: Best Practice; Other: Communication Intervention; Other: Coordination; Other: Educational Intervention; Other: Electronic Health Record Review; Other: Informational Intervention; Other: Interview; Behavioral: Patient Navigation; Other: Referral; Other: Text Message-Based Navigation Intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Follow-up colonoscopy rates

    Evaluated in patients with an abnormal fecal immunochemical test (FIT) result using electronic health record data. Will use a difference-in-differences approach, assessing whether change in completion rates from baseline to the implementation period differs between the intervention and usual care conditions, thus accounting for potential differences among clinics pre-implementation. Will fit a mixed effects logistic regression model with a dependent variable of patient-level colonoscopy completion within 6 months (yes/no).

    Measured: At 6 months

  2. Implementation quality: fit tracker

    The Investigators will measure the percent of cases for which the FIT tracker is used, as well as its use for each step in the process. For these measures, we will also measure time to completion.

    Measured: Monthly intervals up to 3 years

  3. Implementation quality: patient notification

    The Investigators will measure both the percent of patients who are notified of their abnormal results as well as the time to notification.

    Measured: Monthly intervals up to 3 years

  4. Implementation quality: patient referral

    The Investigators will measure the percent of patients who receive a referral.

    Measured: Monthly intervals up to 3 years

  5. Implementation quality: Time to patient referral

    The Investigators will measure the time to patient referral.

    Measured: Monthly intervals up to 3 years

  6. Implementation quality: use of referral template as percent completion of interventions

    The Investigators will measure the percent completion of interventions for patients at each step.

    Measured: Monthly intervals up to 3 years

  7. Implementation quality: referral template in time to completion

    The Investigators will measure the time to completion of interventions.

    Measured: Monthly intervals up to 3 years

  8. Implementation quality: patient education

    The Investigators will measure the percent of cases in which patient education is delivered.

    Measured: Monthly intervals up to 3 years

  9. Implementation quality: patient education

    The Investigators will measure the time to delivery of patient education when it is offered.

    Measured: Monthly intervals up to 3 years

  10. Implementation quality: Patient attendance: completion of a pre-colonoscopy visit

    The Investigators will measure the percent of patients who complete a pre-colonoscopy visit.

    Measured: Monthly intervals up to 3 years

  11. Implementation quality: time to completion of a pre-colonoscopy visit

    The Investigators will measure the time to completion of a pre-colonoscopy visit.

    Measured: Monthly intervals up to 3 years

  12. Implementation quality: receipt of colonoscopy and pathology results at Northeast Valley Health Corporation

    The Investigators will measure the percent of patients for which colonoscopy and pathology results are received at NEVHC.

    Measured: Monthly intervals up to 3 years

  13. Implementation quality: receipt of colonoscopy and pathology results at Northeast Valley Health Corporation over time

    The Investigators will measure the time to retrieval of colonoscopy and pathology results received at NEVHC.

    Measured: Monthly intervals up to 3 years

  14. Cost-effectiveness

    Will use standard cost-effectiveness techniques (including time discounting) to conduct an incremental cost-effectiveness analysis, measuring the Incremental Cost-Effectiveness Ratio of the usual care and Primary-care GI connect intervention conditions.

    Measured: Up to 3 years

Secondary outcomes (6)
  1. Time to colonoscopy

    The Investigators will use a difference-in-differences approach, assessing whether change in completion rates from baseline to the implementation period differs between the intervention and usual care conditions, thus accounting for potential differences among clinics pre-implementation. Will fit a mixed effects logistic regression model with a dependent variable of patient-level colonoscopy completion.

    Measured: 0-24 months

  2. Follow-up colonoscopy rates

    Evaluated in patients with an abnormal FIT result using electronic health record data. Will use a difference-in-differences approach, assessing whether change in completion rates from baseline to the implementation period differs between the intervention and usual care conditions, thus accounting for potential differences among clinics pre-implementation. Will fit a mixed effects logistic regression model with a dependent variable of patient-level colonoscopy completion within 9 months (yes/no).

    Measured: At 9 months and at 12 months

  3. Factors associated with Implementation

    The Investigators will use the Organizational Readiness to Implement Change tool to measure responses from clinic stakeholders at each site. This is a standardized tool.

    Measured: At pre-intervention (1-2 years) and at the implementation midpoint (3-4 years)

  4. Reported challenges to implementation

    In qualitative interviews with stakeholders and on standardized forms, we will learn about major challenges to implementation across clinics and over time. These will be qualitative data.

    Measured: Up to 3 years

  5. Intervention adaptations

    In qualitative interviews with stakeholders, we will learn whether there were any changes we need to be intended intervention components.

    Measured: Up to 3 years

  6. Clinic and provider factors

    The Investigators will use EHR data to measure clinic size, location, staffing, resources, number of providers, number of patients to evaluate associations with successful intervention implementation.

    Measured: At pre-intervention (1-2 years) and at the implementation midpoint (3-4 years)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Aug 2024
  2. Study start22 Apr 2025
  3. Primary completion28 Feb 2029 (estimated)
  4. Study completion31 Aug 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,500 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06568016
Sponsor's protocol ID
24-000532
Other IDs
NCI-2024-05892, 24-000532, P30CA016042
Status last verified
Aug 2026
First submitted
29 Jul 2024
Last updated
2 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Best Practice, Communication Intervention and Coordination in people with Colorectal Carcinoma, run by Jonsson Comprehensive Cancer Center at 2 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 2 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jessica Tuan (310-825-3181, JTuan@mednet.ucla.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Follow-up colonoscopy rates (time frame: At 6 months). The study lists 14 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Sep 2026; AzTrials last refreshed its copy on 1 Nov 2026.

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