A Video Intervention to Decrease Patient Fear of Colonoscopy After a Positive Fecal Immunochemical Test

A Pilot Video Intervention to Decrease Fear of Colonoscopy in a Safety-Net Healthcare System

This clinical trial compares an educational video intervention versus usual care of no video intervention in decreasing patient fear of a colonoscopy procedure after receiving a positive fecal immunochemical test (FIT). The lack of a follow-up colonoscopy after an abnormal FIT result is associated with an increased risk of colorectal cancer mortality, advanced-stage colorectal cancer, among other complications, compared to the completion of a follow-up colonoscopy. An educational video may reduce patient fear and increase knowledge, self-efficacy, and intent to complete a colonoscopy compared to the usual care of no video intervention.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM 1: Patients watch an educational video about the importance of abnormal FIT results, the implications if follow-up colonoscopy is not completed, and demonstrate the steps to complete a colonoscopy.

ARM 2: Patients receive usual care and do not watch the educational video.

After completion of study, patients are followed for 12 months after their abnormal FIT result.

Inclusion Criteria:

• Age 45-75
• Have an assigned primary care provider in our partnering safety-net health system
• Have a billable primary care encounter between 2019-2022
• Have an abnormal FIT result for colorectal cancer (CRC) screening without a colonoscopy within 1 year
• Ability to communicate in English due to initial videos being available in English

Exclusion Criteria:

• Adults < age 45 or > age 75
• Patients who receive care at other University of Washington (UW) medicine sites (non-safety-net patients)
• Individuals without a primary care encounter between 2019-2022
• Individuals whose primary language is not English