Neoplasms

Digestive System Diseases

All Conditions

Colorectal Neoplasms

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Intestinal Diseases

Rectal Diseases

The experimental computer program provides the user with information about colorectal cancer screening that is tailored to their self-efficacy, readiness, and perceived barriers to undergoing screening, in their preferred language (English or Spanish).

This program provides non-tailored, generic information about colorectal cancer screening, in the user's preferred language (English or Spanish).

Personally tailored computer program

This program provides users with non-tailored information about colorectal cancer screening, in their preferred language (English or Spanish).

Non-tailored control computer program

Anthony Jerant, MD

The study investigators have developed an interactive multimedia computer program that provides personally tailored education about colorectal cancer screening in the user's preferred language (English or Spanish). In this study, the investigators will examine whether use of the computer program increases the number of Hispanic patients who receive colorectal cancer screening and lessens or eliminates the glaring disparity in screening between Hispanics and non-Hispanic whites.

* Background: Interactive multimedia computer programs (IMCPs) show promise as a way of delivering personally tailored (PT) information to enhance cognitive mediators of health behavior and improve patient outcomes. However, it is unclear whether PT IMCPs can be deployed in primary care offices to increase cancer screening uptake and eliminate ethnic disparities in uptake by providing PT information in each user's preferred language.
* Aims/Hypotheses: We will compare changes in colorectal cancer (CRC) screening cognitive mediators (self-efficacy, perceived barriers, and readiness) and uptake resulting from an IMCP - PT to enhance the key cognitive mediators and targeted to patients' self-identified ethnicity - with changes resulting from a non-tailored "electronic leaflet" control IMCP. The experimental and control IMCPs will each be offered in English and Spanish versions. We hypothesize that, compared with the appropriate control condition (English, Spanish, or both combined): (1) the English version of the PT IMCP will enhance the cognitive mediators of CRC screening behavior for English-speaking Hispanics and non-Hispanics; (2) there will be similarly favorable changes in these mediators for Hispanics using the Spanish version of the PT IMCP; (3) deployment of the PT IMCP will provide evidence of elimination of disparities in CRC screening between Hispanic and non-Hispanic subjects via its relative impact on the cognitive mediators in these groups; and (4) the PT IMCP (English and Spanish combined) will increase CRC screening uptake in Hispanics and non-Hispanics (considered separately) via changes in the cognitive mediators.
* Methods: Randomized controlled trial of 2 groups, comparing a PT (to the cognitive mediators) CRC screening IMCP offered in both English and Spanish versions and deployed before a primary care office visit with a non-tailored "electronic leaflet" CRC screening IMCP (control) also offered in both English and Spanish. Screening methods targeted will be fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. Primary outcomes will be CRC screening uptake, self-efficacy, perceived barriers, and readiness.
* Implications: Our findings will determine whether an IMCP that is PT to cognitive mediators of screening behavior and deployed in primary care offices prior to previously scheduled visits can activate patients of various ethnicities to undergo CRC screening. They may also suggest a promising, portable method of reducing disparities in CRC (and other) screening uptake between Hispanic and non-Hispanic individuals.

Randomized Controlled Trial of Tailored Interactive Multimedia to Reduce Colorectal Cancer Screening Disparities

University of Rochester

City University of New York, School of Public Health

University of California, Davis

Professor

Symptoms and General Pathology

Pain

Central Nervous System Depressants

All Drugs and Chemicals

Anesthetics

Vaccines

Practice A will consist of the eligible patients empaneled to one of the six participating practices. In the first step, Practice A will be assigned to receive the current care intervention. in the second step, Practice A will be assigned to receive the current care intervention. In the third step, Practice A will receive the reminder-recall intervention. In the fourth step, Practice A will receive the combined reminder-recall and audit-and-feedback intervention.

Practice B will consist of the eligible patients empaneled to one of the six participating practices. In the first step, Practice B will be assigned to receive the current care intervention. In the second step, Practice B will be assigned to receive the reminder-recall intervention. In the third step, Practice B will receive the combined reminder-recall and audit-and-feedback intervention. In the fourth step, Practice A will receive the combined reminder-recall and audit-and-feedback intervention.

Practice C will consist of the eligible patients empaneled to one of the six participating practices. In the first step, Practice C will be assigned to receive the current care intervention. In the second step, Practice C will be assigned to receive the audit-and-feedback intervention. In the third step, Practice C will receive the audit-and-feedback intervention. In the fourth step, Practice C will receive the combined reminder-recall and audit-and-feedback intervention.

Practice D will consist of the eligible patients empaneled to one of the six participating practices. In the first step, Practice D will be assigned to receive the current care intervention. In the second step, Practice D will be assigned to receive the current care intervention. In the third step, Practice D will receive the audit-and-feedback intervention. In the fourth step, Practice D will receive the combined reminder-recall and audit-and-feedback intervention.

Practice E will consist of the eligible patients empaneled to one of the six participating practices. In the first step, Practice E will be assigned to receive the current care intervention. In the second step, Practice E will be assigned to receive the reminder-recall intervention. In the third step, Practice E will receive the reminder-recall intervention. In the fourth step, Practice E will receive the combined reminder-recall and audit-and-feedback intervention.

Practice F will consist of the eligible patients empaneled to one of the six participating practices. In the first step, Practice F will be assigned to receive the current care intervention. In the second step, Practice F will be assigned to receive the audit-and-feedback intervention. In the third step, Practice F will receive the combined reminder-recall and audit-and-feedback intervention. In the fourth step, Practice F will receive the combined reminder-recall and audit-and-feedback intervention.

The current care arm consists of the contemporary efforts now in practice to support provider recommendation including a shared, standard immunization schedule, a shared rooming process, a shared well child visit schedule, a shared electronic prompt at point-of-care of vaccines due.

Current care

The communication will use expectant (announcement-style or presumptive) language noting the child's HPV vaccination status and stating that the child's provider strongly recommends the child receive the HPV vaccination now. The communication will also describe availability of topical anesthetics (less pain), indicate the availability and convenience of nurse visits for HPV vaccination (less fuss), and describe the immunological and logistical benefits of early vaccination (right now).

Reminder-recall

The intervention includes two components. The first is a missed opportunities audit-and-feedback. The second is a provision of a strong recommendation provider-toolkit, along with a broad education of the practice staff-nurses, medical secretaries, receptionists, and clinical assistants-regarding the nature of the intervention, its goals, and its likely impact on the practice. The broad education will be conducted through supervisory communications only to practice staff in practices allocated to the intervention at the beginning of the step.

Audit-and-feedback

The combination reminder-and-audit arm consists of a simultaneous application of the intervention tested in the reminder-recall arm and the intervention tested in the audit-and-feedback arm.

Combined reminder-recall and audit-and-feedback

Robert M Jacobson, MD

Joan M Griffin, PhD

Each year the human papillomavirus (HPV) causes 30,000 cancers in the United States despite the availability of very effective and safe vaccines. Uptake of the HPV vaccine has been disappointingly low and lags behind other adolescent vaccines. This study seeks to test interventions targeting health care system, provider, and patient factors to improve the population uptake of the HPV vaccine.

The broad, long-term objective is to substantially increase human papillomavirus (HPV) vaccination rates by deploying effective population-health interventions in clinical practices across the United States. As part of this effort, the investigators intend to evaluate two evidence-based interventions with innovative enhancements at six Mayo Clinic primary care practices (PCP) to evaluate their individual and combined impact on rates of HPV vaccination among female and male patients. Aim 1, "Less Pain, Less Fuss, Right Now!", will test the hypothesis that, as compared to no intervention (current practice), a practice-level intervention utilizing reminder-recalls featuring the availability of non-medication and medication anesthetics, the convenience of nurse-only visits, and the use of persuasive language for early, on-time vaccinations will improve HPV vaccine delivery rates. Aim 2, "Make It Count!", will test the hypothesis that, as compared to no intervention, a provider level intervention utilizing a missed-opportunities assessment and feedback intervention applying social pressure (specific peer-performance comparisons) and equipping providers with a strong-recommendation toolkit will improve HPV vaccine delivery rates. Aim 3 will test the hypothesis that simultaneous implementation of interventions targeting individual, interpersonal, and organizational factors will have a synergistic effect on HPV vaccine delivery rates. To accomplish Aims 1-3, the investigators will use a stepped-wedge cluster randomized trial with an integrated process evaluation. The cluster approach prevents cross-contamination between patients or providers as we allocate two separate interventions (Aims 1 and 2) in the six PCPs. The stepped-wedge design, which ensures all practices eventually receive the same set of interventions, permits the single institutional review board overseeing all six PCPs to approve the study without requiring recruitment and consent of individual patients or providers. The stepped-wedge approach also permits the investigators to test the presence of each of the interventions in each PCP, making trial participation more attractive, while also allowing each practice to serve as its own control, reducing the bias due to imbalanced risk factors across practices. The factorial design allows the investigators to use a single trial to test two interventions and assess each individually and in combination. The design also conserves sample size while maintaining power. The investigators will measure the impact separately in females and males, 11-12 years of age for the rates of receipt of HPV vaccine doses due. Rigorously tested, highly effective, population-level interventions are essential if the US is to reach the Healthy People 2020 goal for HPV vaccination. The rigor, design, and high likelihood of success of this study will provide key evidence regarding practice- and provider-level interventions to improve HPV vaccination rates. Mayo Clinic's best practices inform not only its own 70 practices across five states but its Mayo Clinic Care Network, which consists of nearly 40 health-care organizations across 26 states and Puerto Rico.

A factorial, stepped-wedge cluster randomized trial with process evaluation

The data analyst will conduct the measurement of the patients eligible and vaccinated and the calculations of the outcomes. The investigators will blind the data analyst to which intervention(s) each practice was assigned to receive. However that only masks the practices' interventions for Step 2 and Step 3 as all practices receive the same interventions in Step 1 (current care) and Step 4 (combined reminder-audit).

Multilevel Interventions to Enhance Provider Recommendations for HPV Vaccination

"Less Pain, Less Fuss, Right Now!" and "Make It Count!"--Multilevel Interventions for Patient, Parent, and Practice to Enhance Provider Recommendations for HPV Vaccination

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible males at each practice, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible 11-year-old males and females at each practice, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible 12-year-old males and females at each practice, measured each month for the 12 months of each step.

Rates of receipt of the first dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice, measured each month for the 12 months of each step.

Rates of receipt of a second valid dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice, measured each month for the 12 months of each step.

Rates of receipt of a third valid dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice who are empaneled to family physicians, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice who are empaneled to pediatricians, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice who are empaneled to family medicine nurse practitioners, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice who are empaneled to pediatric nurse practitioners, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice who are empaneled to family medicine residents, measured each month for the 12 months of each step.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible females at each practice who are empaneled to pediatric residents, measured each month for the 12 months of each step.

By provider, rates of encounters of patients seen in the preceding month who were 9 to 26 years of age and due for a dose of HPV vaccine and received an HPV vaccine the day of that encounter.

Rates of at least one dose of HPV-vaccine for empaneled, vaccine-eligible males and females at each practice, measured each month for the 12 months of each step.

Rates of receipt of the first valid dose for the initiation of the HPV vaccine series for empaneled, vaccine-eligible males and females at each practice, measured each month for the 12 months of each step.

Rates of receipt of the last valid dose for the completion of the HPV vaccine series for empaneled, vaccine-eligible males and females at each practice, measured each month for the 12 months of each step.

National Cancer Institute (NCI)

Mayo Clinic

Professor of Pediatrics

Mouth and Tooth Diseases

Rare Diseases

Mouth Neoplasms

Head and Neck Neoplasms

Mouth Diseases

Stomatognathic Diseases

Oral Cancer

Lip and Oral Cavity Cancer

Antineoplastic Agents

Everolimus

Exemestane

Letrozole

Nilotinib

Sunitinib

Imatinib Mesylate

Deferasirox

Adults (18 years old or more) with one of the following oral oncology treatments: letrozole, exémestane, imatinib, sunitinib, nilotinib, evérolimus, déférasirox

Bugnon Olivier, Professor

Lüthi François, Dr

Schneider Marie-Paule, PhD

Chevaux Bernard, Dr

Troxler Stéphanie, PhD Student

Leila Achtari, MD

The purpose of this study is to implement a support interdisciplinary program(oncologists, pharmacists, physicians, nurses, leagues against cancer) of medication adherence to oral oncology treatments. The aim is to ensure continuity of care between professionals,effectiveness of treatment and patient safety.

80 patients will be included in swiss-romande hospitals and private oncologists and followed by thirty study pharmacies. Each refusal and drop-out will be documented. Follow-up duration is 48 weeks, with a motivational interviewing at least every three months. Patient adherence will be assessed electronically by MEMS (Medication Event Monitoring System).

Collaborative Seamless Care in Oncology : Measure and Reinforce Safety and Adherence to Oral Cancer Treatment

Collaborative and Seamless Care in Oncology : a Study in Primary Care to Measure and Reinforce Safety and Adherence to Oral Cancer Treatment

MEMS data, completed by informations given in motivational interviewing

Evaluating the implementation of the program in pharmacies

By MEMS data and motivational interviewing informations

To evaluate the frequency and severity of ADR and the pharmacist's contribution to their management. Data from motivational interviewing.

Centre Hospitalier Universitaire Vaudois

Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland

Skin and Connective Tissue Diseases

Skin Neoplasms

Skin Diseases

Dermatologic Agents

The aim of the first part of the study is to evaluate patients' skin monitoring habits, their knowledge of skin cancer, and their preconceptions about new telemedicine tools such as teledermoscopy. This is a written quantitative questionnaire with answers to tick.

An explanatory folder will be given to patients and they will be asked to read it beforehand in order to allow a good understanding of the terms used and the goal of the project. This part will include 70 to 100 patients.

The second part of the study is a qualitative study and the aim of it is to evaluate the satisfaction, acceptance and future expectations of those who have benefited from teledermoscopy. Individual and anonymous interviews, lasting 15 to 20 minutes, intended for patients who have benefit of teledermoscopy at the office. An explanatory folder will also be given to the patients concerned in order to explain to them the procedure of the interview. This part will include 8 to 10 patients.

If there is any diagnostic doubt about a skin lesion, teledermoscopy will be used, if the patient agrees.

* A table containing the useful information about the patient for the lesion's analysis will be completed.
* The pictures will be taken with a Fotofinder Handyscope. The photos will be integrated into the patient's electronic medical record (CareConnect program).
* The photo is anonymized via a serial number assigned by the "Handyscope" application.
* Sending photos and information via a secure email address to the dermatologists.
* Response from the dermatologist (Prof. Tromme or Dr Harkemanne) in the following days also via email.
* Contact (consultation or telephone call depending on the diagnosis) with the patient to communicate the results and the procedure to be followed.
* This information (emails containing the dermatological report) will be saved in the patient's computerized medical file (CareConnect program) then deleted from the mailbox

taking macroscopic and dermoscopic pictures of suspicious skin lesions

Odile MAGOTTEAUX, Dr

Isabelle Tromme, Dr

The aim objective of this work is to assess the characteristics of patients for whom teledermoscopy could be suitable for the detection of potential skin cancers, within a population of rural general medicine in the South of Hainaut, by means of a mixed quantitative and qualitative study corresponding respectively:

* To identify patients' knowledge of skin cancers, their skin monitoring habits, and their acceptability of new telemedicine tools such as teledermoscopy ("Part 1").
* To evaluate the satisfaction and expectations of those who benefit from teledermoscopy ("Part 2").

Patient Acceptance And Satisfaction of Teledermoscopy In General Practice In a Belgian Rural Area

Evaluation of Patients Acceptance and Satisfaction With Teledermoscopy at the General Practionner's Office for the Detection of Skin Cancer in a Rural Area.

Using a quantitative survey-type questionnaire

* Determination of the patients ' skin monitoring habits
* Determination of patients' knowledge of skin cancers and their prevention
* Determine their acceptance of new technologies such as teledermoscopy in the context of skin cancer screening
* And finally, determination of a target population for whom teledermoscopy could be suitable for the detection of skin cancers (percentage of patients accepting teledermoscopy etc)

Assessment of the satisfaction and future expectations of patients who have benefited from teledermoscopy in general practice, using a qualitative study in the form of semi-structured, individual and anonymous interviews

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Randomized Controlled Trial of Tailored Interactive Multimedia to Reduce Colorectal Cancer Screening Disparities	NCT00786747	Colorectal Neop...	Personally tail... Non-tailored co...	50 Years - 75 Years	University of California, Davis
Multilevel Interventions to Enhance Provider Recommendations for HPV Vaccination	NCT03501992	Papillomavirus ...	Current care Reminder-recall Audit-and-feedb... Combined remind...	11 Years - 12 Years	Mayo Clinic
Collaborative Seamless Care in Oncology : Measure and Reinforce Safety and Adherence to Oral Cancer Treatment	NCT01370980	Cancer		18 Years -	Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland
Multilevel Interventions to Enhance Provider Recommendations for HPV Vaccination	NCT03501992	Papillomavirus ...	Current care Reminder-recall Audit-and-feedb... Combined remind...	11 Years - 12 Years	Mayo Clinic
Patient Acceptance And Satisfaction of Teledermoscopy In General Practice In a Belgian Rural Area	NCT04534868	Skin Cancer Patient Accepta... Patient Satisfa...	taking macrosco...	18 Years -	Cliniques universitaires Saint-Luc- Université Catholique de Louvain
Collaborative Seamless Care in Oncology : Measure and Reinforce Safety and Adherence to Oral Cancer Treatment	NCT01370980	Cancer		18 Years -	Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland
Collaborative Seamless Care in Oncology : Measure and Reinforce Safety and Adherence to Oral Cancer Treatment	NCT01370980	Cancer		18 Years -	Center for Primary Care and Public Health (Unisante), University of Lausanne, Switzerland

Spots Global Cancer Trial Database for patient acceptance of health care