• primary prevention;
  • cancer screening;
  • colonic neoplasms;
  • intervention studies;
  • prepaid health plans



Evidence-based interventions have been found effective in increasing colorectal cancer (CRC) screening. Translating these successful interventions into real world settings, such as health plans, can be challenging.


CHOICE (Communicating Health Options through Information and Cancer Education) is a controlled trial to test the effectiveness of a patient- and practice-level intervention to increase use of recommended CRC screening tests. The patient-level intervention was a patient decision aid and stage-targeted brochures, mailed to eligible health plan members, to provide information about CRC, available screening tests, and how to obtain CRC screening at their physicians' practices. The practice-level intervention was academic detailing to prepare practices to facilitate CRC testing once the patient was activated by the decision aid. Surveys and claims data will be used to assess CRC screening test completion.


Thirty-two primary care practices in Florida and Georgia participated. The authors recruited 443 participating health plan members for the trial; 211 were patients in intervention practices, and 232 were in usual care practices. Study participants reflected an insured population; the majority were white and aged <60 years. The authors also mailed the intervention to 343 people from intervention practices who did not respond to the eligibility or baseline survey. Receipt of screening in that group will be compared with screening among 319 people from usual care practices who did not respond to these surveys using claims data.


The CHOICE study will demonstrate the effect of 2 combined evidence-based interventions on CRC screening test completion among health plan members. Cancer 2010. © 2010 American Cancer Society.