Colorectal CancerNCT04313114
The PRIME-CRC Trial to Promote CRC Screening in Rural Communities
A study testing health literacy appropriate education and demonstration, shared decision making and automated call reminders or automated texts in people with Colorectal Cancer, run by Louisiana State University Health Sciences Center Shreveport at 3 sites in United States.
Trial summary
The investigators will expand an existing, patient-centered, health literacy strategy to promote longer-term adherence to colorectal cancer (CRC) screening in resource-limited, rural health clinics via colonoscopy or annual fecal immunochemical test (FIT). Read more about this study
- Who is it for?
- Ages 45 to 75 yearsHealthy volunteers can take part
- Conditions the study is for
- Colorectal Cancer
- What is being tested?
- health literacy appropriate education and demonstration, shared decision making and automated call reminders or automated texts
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 804 participants
- Where
- 3 sitesUnited States
- Study dates
- 20 Sep 2021to 31 May 2027
- 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 45 to 75 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- have been a patient at one of the participating FQHCs with at least one prior visit in the past 12 months;
- age 45 to 75 (based on USPSTF guidelines);
- English-speaking.
Who cannot join
- have a previous history of cancer other than non-melanoma skin cancer;
- are up-to-date with CRC screening according to USPSTF guidelines (FOBT in less than a year, sigmoidoscopy less than 5 years, or colonoscopy less than 10 years);
- a family history that requires a more complete history and possible colonoscopy because of their risk factor;
- have a documented or uncorrectable cognitive, hearing, or visual impairment;
- are too ill to participate
Trial locations and contacts
3 sites in 1 country.
United States3 sites
CommuniHealth (dba Morehouse Community Medical Centers, Inc.)
Bastrop, Louisiana, 71220-5013
CommuniHealth (dba Morehouse Community Medical Centers, Inc.)
Marion, Louisiana, 71260-3653
Tensas Community Health Centers
Saint Joseph, Louisiana, 71366
About this study
Official title: Patient-Centered Reminders to Inform, Motivate, and Engage Colorectal Cancer Screening Adherence in Rural Communities: The PRIME-CRC Trial
The investigators will expand an existing, patient-centered, health literacy strategy to promote longer-term adherence to colorectal cancer (CRC) screening in resource-limited, rural health clinics via colonoscopy or annual fecal immunochemical test (FIT). In the proposed 2-arm study, both PRIME-CRC and enhanced usual care (control) will incorporate health literacy evidence-based practices for delivering CRC patient information and counseling to aid patient decision making for selecting FIT or colonoscopy, including simplified test instructions. In addition, the PRIME-CRC arm will use a "stepped care" approach for reminding patients on proper CRC screening preparation for scheduled colonoscopy or completion of annual FIT. Patients in the PRIME-CRC arm will receive frequent follow-up contact from their health care provider via audio-recorded, automated call or SMS text, based on patient preference.
Read the detailed description
The investigators will expand an existing, patient-centered, health literacy strategy to promote longer-term adherence to colorectal cancer (CRC) screening in resource-limited, rural health clinics via colonoscopy or annual fecal immunochemical test (FIT). Guided by recently completed trials, the investigators will leverage consumer technologies that are now available in rural areas and implement a multifaceted approach - designed for scale in resource-limited federally qualified health centers (FQHCs). While significant gains have been made to improve CRC screening, compliance with those guidelines is sub-optimal and disparities remain. In particular, adults who receive care at rural FQHCs that have limited resources struggle to initiate and maintain annual CRC screening via the most common method, FIT. Over the past decade, this team has studied the effectiveness of specific interventions to enhance initial and repeat CRC screening completion among lower income, lower health literate, racially/ethnically diverse adults in rural FQHC settings. The majority of patients will complete the initial test (67% - 69%), yet fewer (32% - 40%) complete an annual test in years 2 and 3. This indicates a "stepped care" approach is needed to promote long-term CRC screening. The investigators' rural health literacy interventions have until now been limited to the FIT due to restrictions of state Medicaid coverage and clinical bandwidth of colonoscopy services available to rural FQHCs. Changes to Medicaid have now expanded the availability of colonoscopy. The investigators propose a novel intervention guided by evidence learned from the investigators' previous studies and recent literature - the Patient-Centered Reminders to Inform, Motivate, and Engage-CRC Screening (PRIME-CRC). In this proposed 2-arm, randomized control trial (N=1200), both PRIME-CRC and enhanced usual care arms will at point of care receive CRC patient information and counseling to aid patient decision making for selecting FIT or colonoscopy utilizing core components including evidence-based Health Literacy education and counseling, along with printed, simplified CRC screening information and simplified test instructions. PRIME-CRC will additionally have a "stepped care" approach for reminding patients on proper CRC screening preparation for scheduled colonoscopy or completion of annual FIT. Patients in the PRIME-CRC arm will have frequent follow-up with tailored contact via automated call or SMS text (based on patient preference) from their healthcare provider (audio recorded or personalized text). The primary outcome will be completion of either colonoscopy or annual FIT over 3 years. The specific aims are to: test the effectiveness of the PRIME-CRC intervention to improve CRC screening completion rates in rural FQHCs compared to enhanced usual care; investigate whether the intervention can reduce CRC screening disparities by patient health literacy, race or sex; determine the fidelity of PRIME-CRC components, and explore patient, provider, and healthcare system barriers to implementation, and evaluate the cost associated with the intervention from a FQHC perspective. This study extends this team's longstanding collaboration on health literacy, health disparities, rural health and cancer screening.
- Conditions
- Colorectal Cancer
- Being tested
- health literacy appropriate education and demonstration, shared decision making, automated call reminders or automated texts
- Keywords
- health literacy, shared decision making, colonoscopy, fecal immunochemical test, rural community clinics
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
health literacy appropriate education and demonstrationBehavioural
If a patient chooses the Fecal Immunochemical Test (FIT), the Screening Coordinator (SC) will give the FIT kit, emphasize the necessity of annual completion, and distribute an additional plain language, literacy appropriate, actionable handout with simplified illustrated instructions on how to complete the test and mail to the central lab. The SC will review the handout and instructions with the patient and use the 'teach back' method to confirm understanding.
shared decision makingBehavioural
Screening Coordinator (SC) will give patients a plain language, literacy appropriate, actionable printed CRC screening handout emphasizing the benefits of CRC screening and screening options; using the low literacy handout as a teaching tool, the SC will briefly counsel patients on CRC screening options prior to seeing their healthcare provider, reviewing the benefits of each, as well as applicable costs. After reviewing the CRC screening pamphlets with a patient, the SC will use shared decision-making techniques using the study CRC materials to aid patients in selecting the test they prefer and that meets their needs - colonoscopy or FIT.
automated call reminders or automated textsBehavioural
Colonoscopy year 1: Will receive an automated call recording by PCP 48 hours after the clinic visit to remind them of their choice of colonoscopy; then, one week before the test reminding them to pick up the preparation kit. Those who chose SMS will receive a text message from their PCP with content similar to the voice call. A 3rd reminder call/text will be sent 2 days prior to the test. If no colonoscopy with 3 months, the clinical manager (CCM) will call to determine if they want to switch screening options. The CCM will discuss barriers and option of choosing FIT for 3 years. If they opt to change, they will be mailed a FIT with simplified instructions and then follow the FIT follow-up protocol.
FIT year 1: Motivational reminders recorded by their PCP will be sent by automated call or text within 48 hours after the visit and again at 4, 8 and 12 weeks for those who have NOT completed the test. FIT will be mailed year 2 \& 3 - follow-up will follow same procedure as year 1.
| Study group | Role | What they receive |
|---|---|---|
| PRIME CRC | Active comparator | Patients will receive a plain language, literacy appropriate, actionable printed CRC screening handout emphasizing the benefits of CRC screening and screening options; as well as plain language, literacy appropriate handouts on the CRC screening test they choose - colonoscopy or FIT. Patients will also receive automated reminder calls and texts for both screening options to encourage screening. Receives: Behavioral: health literacy appropriate education and demonstration; Behavioral: shared decision making; Behavioral: automated call reminders or automated texts |
| Enhanced Usual Care | Active comparator | Patients will receive a plain language, literacy appropriate, actionable printed CRC screening handout emphasizing the benefits of CRC screening and screening options; as well as plain language, literacy appropriate handouts on the CRC screening test they choose - colonoscopy or FIT. Patients will receive no reminder calls. Receives: Behavioral: health literacy appropriate education and demonstration; Behavioral: shared decision making |
What is being measured
The primary outcome is the main question the study is designed to answer.
CRC Screening
completion of colonoscopy or 3 years of completion of FIT CRC screening
Measured: 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Mar 2020
- Study start20 Sep 2021
- Primary completion1 Mar 2026
- Study completion31 May 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Colorectal CancerStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Screening
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 804 participants (actual)
Sponsor and investigators
- Lead sponsor
- Louisiana State University Health Sciences Center Shreveport
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI), Northwestern University
- Responsible party
- Sponsor
- Investigators
- Connie L Arnold, PhD, Principal investigator, LSU Health Sciences Center Shreveport
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04313114
- Sponsor's protocol ID
- LSUShreveport
- Other IDs
- 5R01CA240496
- Status last verified
- Oct 2026
- First submitted
- 16 Mar 2020
- Last updated
- 28 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: The investigators will provide and disseminate a complete IRB approved study protocol describing the study sample, all research questions, analysis methods, description of measures and procedures with the first progress report. The investigators will maintain primary data in accordance with NIH regulations. The investigators will consider requests for primary study data from other researchers and from the public, in light of our intent to publish, and will make data available in accordance with institutional policies, IRB rules, and local/state/federal laws and regulations. For interested researchers, the investigators will make anonymized, aggregated data available to researchers who complete a data sharing use agreement in compliance with the Louisiana State University Health Sciences Center - Shreveport.
Publications
Davis TC, Morris JD, Reed EH, Curtis LM, Wolf MS, Davis AB, Arnold CL. Design of a randomized controlled trial to assess the comparative effectiveness of a multifaceted intervention to improve three-year adherence to colorectal cancer screening among patients cared for in rural community health centers. Contemp Clin Trials. 2022 Feb;113:106654. doi: 10.1016/j.cct.2021.106654. Epub 2021 Dec 11.
PubMed 34906745
Study at a glance
From the registry record, last updated by the sponsor on 28 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Patient-Centered Reminders to Inform, Motivate, and Engage Colorectal Cancer Screening Adherence in Rural Communities: The PRIME-CRC Trial
- ClinicalTrials.gov ID
- NCT04313114
- Acronym / sponsor ID
- LSUShreveport
- Conditions
- Colorectal Cancer
- Keywords
- health literacy, shared decision making, colonoscopy, fecal immunochemical test, rural community clinics
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 804 participants (actual)
- Lead sponsor
- Louisiana State University Health Sciences Center ShreveportUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI), Northwestern University
- Study start
- 20 Sep 2021 (actual)
- Primary completion
- 1 Mar 2026 (actual)
- Study completion
- 31 May 2027 (estimated)
- First posted
- 18 Mar 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The investigators will expand an existing, patient-centered, health literacy strategy to promote longer-term adherence to colorectal cancer (CRC) screening in resource-limited, rural health clinics via colonoscopy or annual fecal immunochemical test (FIT). In the proposed 2-arm study, both PRIME-CRC and enhanced usual care (control) will incorporate health literacy evidence-based practices for delivering CRC patient information and counseling to aid patient decision making for selecting FIT or colonoscopy, including simplified test instructions. In addition, the PRIME-CRC arm will use a "stepped care" approach for reminding patients on proper CRC screening preparation for scheduled colonoscopy or completion of annual FIT. Patients in the PRIME-CRC arm will receive frequent follow-up contact from their health care provider via audio-recorded, automated call or SMS text, based on patient preference.
Detailed description
The investigators will expand an existing, patient-centered, health literacy strategy to promote longer-term adherence to colorectal cancer (CRC) screening in resource-limited, rural health clinics via colonoscopy or annual fecal immunochemical test (FIT). Guided by recently completed trials, the investigators will leverage consumer technologies that are now available in rural areas and implement a multifaceted approach - designed for scale in resource-limited federally qualified health centers (FQHCs). While significant gains have been made to improve CRC screening, compliance with those guidelines is sub-optimal and disparities remain. In particular, adults who receive care at rural FQHCs that have limited resources struggle to initiate and maintain annual CRC screening via the most common method, FIT. Over the past decade, this team has studied the effectiveness of specific interventions to enhance initial and repeat CRC screening completion among lower income, lower health literate, racially/ethnically diverse adults in rural FQHC settings. The majority of patients will complete the initial test (67% - 69%), yet fewer (32% - 40%) complete an annual test in years 2 and 3. This indicates a "stepped care" approach is needed to promote long-term CRC screening. The investigators' rural health literacy interventions have until now been limited to the FIT due to restrictions of state Medicaid coverage and clinical bandwidth of colonoscopy services available to rural FQHCs. Changes to Medicaid have now expanded the availability of colonoscopy. The investigators propose a novel intervention guided by evidence learned from the investigators' previous studies and recent literature - the Patient-Centered Reminders to Inform, Motivate, and Engage-CRC Screening (PRIME-CRC). In this proposed 2-arm, randomized control trial (N=1200), both PRIME-CRC and enhanced usual care arms will at point of care receive CRC patient information and counseling to aid patient decision making for selecting FIT or colonoscopy utilizing core components including evidence-based Health Literacy education and counseling, along with printed, simplified CRC screening information and simplified test instructions. PRIME-CRC will additionally have a "stepped care" approach for reminding patients on proper CRC screening preparation for scheduled colonoscopy or completion of annual FIT. Patients in the PRIME-CRC arm will have frequent follow-up with tailored contact via automated call or SMS text (based on patient preference) from their healthcare provider (audio recorded or personalized text). The primary outcome will be completion of either colonoscopy or annual FIT over 3 years. The specific aims are to: test the effectiveness of the PRIME-CRC intervention to improve CRC screening completion rates in rural FQHCs compared to enhanced usual care; investigate whether the intervention can reduce CRC screening disparities by patient health literacy, race or sex; determine the fidelity of PRIME-CRC components, and explore patient, provider, and healthcare system barriers to implementation, and evaluate the cost associated with the intervention from a FQHC perspective. This study extends this team's longstanding collaboration on health literacy, health disparities, rural health and cancer screening.
Study design
- Primary purpose
- Screening
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| PRIME CRC | Active comparator | Behavioral: health literacy appropriate education and demonstration, Behavioral: shared decision making, Behavioral: automated call reminders or automated textsPatients will receive a plain language, literacy appropriate, actionable printed CRC screening handout emphasizing the benefits of CRC screening and screening options; as well as plain language, literacy appropriate handouts on the CRC screening test they choose - colonoscopy or FIT. Patients will also receive automated reminder calls and texts for both screening options to encourage screening. |
| Enhanced Usual Care | Active comparator | Behavioral: health literacy appropriate education and demonstration, Behavioral: shared decision makingPatients will receive a plain language, literacy appropriate, actionable printed CRC screening handout emphasizing the benefits of CRC screening and screening options; as well as plain language, literacy appropriate handouts on the CRC screening test they choose - colonoscopy or FIT. Patients will receive no reminder calls. |
Who may qualify
- Ages
- 45 to 75 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- have been a patient at one of the participating FQHCs with at least one prior visit in the past 12 months;
- age 45 to 75 (based on USPSTF guidelines);
- English-speaking.
Key exclusion criteria (5 listed)
- have a previous history of cancer other than non-melanoma skin cancer;
- are up-to-date with CRC screening according to USPSTF guidelines (FOBT in less than a year, sigmoidoscopy less than 5 years, or colonoscopy less than 10 years);
- a family history that requires a more complete history and possible colonoscopy because of their risk factor;
- have a documented or uncorrectable cognitive, hearing, or visual impairment;
- are too ill to participate
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| health literacy appropriate education and demonstrationIf a patient chooses the Fecal Immunochemical Test (FIT), the Screening Coordinator (SC) will give the FIT kit, emphasize the necessity of annual completion, and distribute an additional plain language, literacy appropriate, actionable handout with simplified illustrated instructions on how to complete the test and mail to the central lab. The SC will review the handout and instructions with the patient and use the 'teach back' method to confirm understanding. | Behavioural | Enhanced Usual Care, PRIME CRC |
| shared decision makingScreening Coordinator (SC) will give patients a plain language, literacy appropriate, actionable printed CRC screening handout emphasizing the benefits of CRC screening and screening options; using the low literacy handout as a teaching tool, the SC will briefly counsel patients on CRC screening options prior to seeing their healthcare provider, reviewing the benefits of each, as well as applicable costs. After reviewing the CRC screening pamphlets with a patient, the SC will use shared decision-making techniques using the study CRC materials to aid patients in selecting the test they prefer and that meets their needs - colonoscopy or FIT. | Behavioural | Enhanced Usual Care, PRIME CRC |
| automated call reminders or automated textsColonoscopy year 1: Will receive an automated call recording by PCP 48 hours after the clinic visit to remind them of their choice of colonoscopy; then, one week before the test reminding them to pick up the preparation kit. Those who chose SMS will receive a text message from their PCP with content similar to the voice call. A 3rd reminder call/text will be sent 2 days prior to the test. If no colonoscopy with 3 months, the clinical manager (CCM) will call to determine if they want to switch screening options. The CCM will discuss barriers and option of choosing FIT for 3 years. If they opt to change, they will be mailed a FIT with simplified instructions and then follow the FIT follow-up protocol. FIT year 1: Motivational reminders recorded by their PCP will be sent by automated call or text within 48 hours after the visit and again at 4, 8 and 12 weeks for those who have NOT completed the test. FIT will be mailed year 2 \& 3 - follow-up will follow same procedure as year 1. | Behavioural | PRIME CRC |
Primary outcome
CRC Screening
Time frame: 3 years
completion of colonoscopy or 3 years of completion of FIT CRC screening
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Oct 2026.
- Derived from this study: PubMed 34906745Davis TC, Morris JD, Reed EH, Curtis LM, Wolf MS, Davis AB, Arnold CL. Design of a randomized controlled trial to assess the comparative effectiveness of a multifaceted intervention to improve three-year adherence to colorectal cancer screening among patients cared for in rural community health centers. Contemp Clin Trials. 2022 Feb;113:106654. doi: 10.1016/j.cct.2021.106654. Epub 2021 Dec 11.
- Individual participant dataSharing planned: No. The investigators will provide and disseminate a complete IRB approved study protocol describing the study sample, all research questions, analysis methods, description of measures and procedures with the first progress report. The investigators will maintain primary data in accordance with NIH regulations. The investigators will consider requests for primary study data from other researchers and from the public, in light of our intent to publish, and will make data available in accordance with institutional policies, IRB rules, and local/state/federal laws and regulations. For interested researchers, the investigators will make anonymized, aggregated data available to researchers who complete a data sharing use agreement in compliance with the Louisiana State University Health Sciences Center - Shreveport.
Related trials for Colorectal Cancer
Not yet recruitingPhase 1
Hepatic Artery Infusion of Carfilzomib in Participants With Liver Metastatic Disease Previously Treated With Hepatic Artery Infusion Pump Therapy
Colorectal Neoplasms, Neoplasms
Active, not recruiting
Streamlined Geriatric and Oncological Evaluation Based On IC Technology
Breast Cancer, Comorbidities and Coexisting Conditions
RecruitingObservational study
Pre- and On-treatment Multi-omics Profiling of Locally Advanced Rectal Cancer
Rectal Neoplasms
Enrolling by invitationObservational study
Natural History Study of Early Life Exposures in Agriculture (ELEA)
Prostate Cancer, Leukemia
RecruitingPhase 2
Tislelizumab in People With Colorectal Cancer
Colorectal Cancer
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Connie L Arnold, PhD principal investigator
LSU Health Sciences Center Shreveport
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing health literacy appropriate education and demonstration, shared decision making and automated call reminders or automated texts in people with Colorectal Cancer, run by Louisiana State University Health Sciences Center Shreveport at 3 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 3 inclusion and 5 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: under way, not looking for participants, as of the sponsor's last update on 28 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 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?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
CRC Screening (time frame: 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04313114, which also lists 1 linked publication.
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 28 Oct 2026.