Prompting and Reminding at Encounters for Prevention

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DESCRIPTION (provided by applicant) The Prompting & Reminding at Encounters for Prevention (PREP) project is designed to evaluate the implementation of a specific method of delivering reminders for colorectal cancer screening. It will study the implementation of a computerized reminder system, ClinfoTracker, in 12 community practices belonging to the Michigan Great Lakes Research Into Practice Network (GRIN). This system has been developed and used to date in a group of University of Michigan affiliated community practices. We propose to evaluate its implementation in 12 statewide community practices with a varied set of infrastructures. In a series of assessments, we will evaluate 49 already identified, interested network practices on their ability to implement the colorectal cancer screening reminder system, selecting 12 practices for actual implementation. Following implementation, these practices will he randomized to one of 3 modes of reminding, clinician targeted reminders, patient targeted reminders, and both clinician and patient targeted reminders. The practices will use the reminder system in the assigned mode for 9 months, following which we will perform an in depth assessment of colorectal cancer screening rates and clinician, office staff and patient attitudes and perceptions regarding the reminder system. During this post-assessment phase we will perform baseline and intervention period chart reviews of prompted patients, conduct surveys of clinicians, office staff and patients, as well as detailed observations of how the system integrates into routine practice. At the completion of PREP we will understand how to best implement the reminder system into a variety of practices, we will have effect size estimates of each of the three reminding modes (clinician reminders, patient reminders and clinician and patient reminders). This information will be used to inform the methods and practice sample size calculations for a cluster-randomized effectiveness trial of computerized reminders with adequate power to determine the best mode of delivering reminders for colorectal cancer screening.