Background: Latino immigrants face a higher burden of colorectal cancer (CRC) and screening rates are low. Objective: To assess the effectiveness of a multilevel intervention in increasing the rate of CRC screening among Latino immigrants. Design: A randomized controlled trial, with randomization at the physician level. Participants: Pairs of 65 primary care physicians and 65 Latino immigrant patients participated, 31 in the intervention and 34 in the control group. Intervention: 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. Measurements: Completed CRC screening, physician recommendation for CRC screening, and patient adherence to physician recommended CRC screening. Results: 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). Conclusions: 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. © 2010 Society of General Internal Medicine.

Primary care Immigrant health intervention Colorectal cancer prevention

urban population immigrant primary medical care controlled clinical trial mass screening control group clinical trial videotape human middle aged colorectal cancer controlled study randomized controlled trial Colorectal Neoplasms cancer screening screening test Cultural Competency Early Detection of Cancer Hispanic Americans Patient Education as Topic Humans Hispanic male Emigrants and Immigrants female medical information system clinical article Article intervention study adult health education physician patient participation outcome assessment health care facility primary health care