Improving colorectal cancer screening rates using motivational interviewing

Background and objective: Early diagnosis of colorectal cancer (CRC) through screening is associated with survival rates of more than 90%. Nearly half of American adults are not compliant with recommendations. The purpose of this project is to implement and evaluate an evidenced based protocol utilizing motivational interviewing as an intervention to improve CRC screening rates among a Veteran population. Methods: The project design includes a single session telephone based motivational interviewing session two weeks after receipt of fecal immunochemical test (FIT) for home screening. A motivational interview roadmap was developed to guide the telephone session. Results: All participants were male and 76% had previously completed a CRC screening test. Fourteen percent (n = 7/50) of participants returned their FIT within 2 weeks. Of the 38 participants eligible for telephone based motivational interview 66% (n = 25) were unreachable by telephone and received one or two voicemail messages that stressed the importance of returning the FIT. Of the motivational interviewing recipients, 62% (n = 8/13) successfully returned their FIT. Conclusions: These results provide beginning evidence for the effectiveness of motivational interviewing to improve CRC screening rates. Issues with system processes and healthcare provider behaviors were identified and recommendations for improvement are provided.