Acceptability of Physician Directed Academic Detailing to Increase Colorectal Cancer Screening: an Application of the RESPECT Approach

• Main Authors: Gwen Lawson (Author), Corey H. Basch (Author), Patricia Zybert (Author), Randi L. Wolf (Author), Charles E. Basch (Author)
• Format: Book
• Published: Tabriz University of Medical Sciences, 2015-10-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2228-6497; 10.15171/hpp.2015.020
• Keywords: Colorectal cancer; Screening; Colonoscopy; Academic detailing; Nutrition. Foods and food supply; TX341-641; Public aspects of medicine; RA1-1270
• Source: Health Promotion Perspectives, Vol 5, Iss 3, Pp 169-175 (2015)

Background: In developing effective interventions to increase colorectal cancer (CRC) screening in at risk populations, a necessary first requirement is feasibility. This paper describes how the RESPECT approach to health education guided the conceptualization and implementation of physician-directed academic detailing (AD) to increase practice-wide CRC screening uptake. Methods: Physician-directed AD was one intervention component in a large educational randomized controlled trial to increase CRC screening uptake. Study participants, primarily urban minority, were aged 50 or older, insured for CRC screening with no out-of-pocket expense and out of compliance with current screening recommendations. The trial was conducted in the New York City metropolitan area. Participants identified their primary care physician; 564 individuals were recruited, representing 459 physician practices. Two-thirds of the physician practices were randomized to receive AD. The RESPECT approach, modified for AD, comprises: 1) Rapport, 2) Educate, but don't overwhelm, 3) Start with physicians where they are, 4) Philosophical orientation based on a humanistic approach to education, 5) Engagement of the physician and his/her office staff, 6) Care and show empathy, and 7) Trust. Feasibility was assessed as rate of AD delivery. Results: The AD was delivered to 283 (92.5%) of the 306 practices assigned to receive it; 222/283 (78.4%) delivered to the doctor. Conclusion: The AD was feasible and acceptable to implement across a range of clinical settings. The RESPECT approach offers a framework for tailoring educational efforts, allowing flexibility, as opposed to strict adherence to a highly structured script or a universal approach.