Improving Colorectal Cancer Screening Uptake Through Education and Stool-Based Testing Outreach

August 19, 2026 updated by: Washington University School of Medicine

Improving Colorectal Cancer Screening Uptake Through Patient-Centered Education and Mailed Stool-Based Testing Outreach in the Primary Care Medicine Clinic

This is a mixed-methods implementation pilot combining an educational intervention with a mailed stool-based testing outreach feasibility study within a resident primary care clinic. Participants will be assigned by clinic team to education, mailed FIT, mailed Cologuard, or usual care comparison groups.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

200

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Cassandra Fritz, MD, MPHS
  • Phone Number: 314-454-8165
  • Email: cfritz@wustl.edu

Study Locations

    • Missouri
      • St Louis, Missouri, United States, 63110
        • Washington University School of Medicine
        • Contact:
        • Contact:
        • Sub-Investigator:
          • Kamilah Scales, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Phase 1 Education Arm Inclusion Criteria:

  • Previously enrolled in prior study IRB #202202059 who agreed to participate in future research

Phase 1 Education Arm Exclusion Criteria:

  • Not enrolled in prior study IRB #202202059

Phase 2 (All Other Arms) Inclusion Criteria:

  • Primary Care Medicine Clinic patient (PRMC)
  • Eligible for CRC screening
  • Between age 45-75 years old
  • Have eligible health insurance

Phase 2 (All Other Arms) Exclusion Criteria:

  • Prior history of colorectal cancer
  • Diagnosis of inflammatory bowel disease

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Screening
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Education
Participants will complete the Assessment of Colon Cancer Literacy (ACCL) as a pre-test prior to receiving education materials. After the pre-test, participants will be provided with ACCL education materials. Three months after being provided education materials, participants will repeat ACCL testing.
Education materials are compiled from the American College of Gastroenterology (ACG) and the City of Hope. The education materials are at a 6th grade reading level. Materials detail digestive system and polyp background, colorectal cancer (CRC) risk factors, warning signs, screening options, recommended initial screening age, and stool-based screening and colonoscopy processes.
Experimental: Mailed FIT

Participants will receive a mailed package including 1 FIT test, step-by-step written and pictorial instructions, a prepaid, trackable return envelope, a brief explanation of how the testing works and how results will be communicated, and education materials about CRC. Participants who return kits will complete the Client Satisfaction Questionnaire (CSQ-3) by phone or via MyChart.

Participants will be contacted three times by phone as reminders to complete the kit. After three reminders, the team will stop attempting to contact the patient.

The Fecal immunochemical test (FIT) will be mailed to the participants. Participants will complete the test via the step-by-step written and pictorial instructions provided and mail the complete test with the pre-paid return label provided.
Experimental: Mailed Cologuard

Participants will receive a mailed package including 1 Cologuard test, step-by-step written and pictorial instructions, a prepaid, trackable return envelope, a brief explanation of how the testing works and how results will be communicated, and education materials about CRC. Participants will have 3 months to return the kit. Participants who return kits will complete the Client Satisfaction Questionnaire (CSQ-3) by phone or via MyChart.

Participants will be contacted three times by phone as reminders to complete the kit. After three reminders, the team will stop attempting to contact the patient.

The Cologuard test will be mailed to the participants. Participants will complete the test via the step-by-step written and pictorial instructions provided and mail the complete test with the pre-paid return label provided.
Active Comparator: Usual Care
Participants will receive usual care from provider after enrollment with no intervention. Usual care includes providers offering standard screening options including FIT, Cologuard, and colonoscopy at the initial visit with no default option or structured follow-up.
Usual care for patients eligible for colorectal cancer screening will be provided by the Barnes-Jewish Hospital Primary Care Medicine Clinic.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in CRC knowledge (Education Arm only)
Time Frame: At enrollment and 3 months after educational intervention (total estimated time is 3 months)
Change in CRC knowledge will be measured by changes in the score of the Assessment of Colon Cancer Literacy (ACCL) test. The ACCL consists of 10-items with True/False/Unsure. The ACCL score ranges from 0 to 10 with a score of 7-10 indicating adequate literacy and scores of 0-6 indicating limited literacy.
At enrollment and 3 months after educational intervention (total estimated time is 3 months)
Feasibility as measured by the percentage of kits returned (Mailed FIT and Mailed Cologuard Arms only)
Time Frame: At 3 months after receiving kit (total estimated time 3 months)
At 3 months after receiving kit (total estimated time 3 months)
Acceptability of stool based testing (Mailed FIT and Mailed Cologuard Arms only)
Time Frame: At completion of testing or at 3 months after receiving test kit (total estimated time 3 months)
Acceptability will be assessed using the 3-item Customer Service Questionnaire (CSQ-3). The 3-items are rated on a 4-point Likert scale as follows: 1=Poor, 2=Fair, 3=Good, and 4=Excellent. Generally, the higher the score indicates greater customer satisfaction.
At completion of testing or at 3 months after receiving test kit (total estimated time 3 months)
CRC screening completion rate (All arms)
Time Frame: From time of receiving CRC kit to 6 months after receiving kit (total estimated time 6 months)
CRC screening completion rate will be assessed through electronic health record (EHR) verification of screening completion.
From time of receiving CRC kit to 6 months after receiving kit (total estimated time 6 months)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Cassandra Fritz, MD, MPHS, Washington University School of Medicine

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

September 30, 2026

Primary Completion (Estimated)

March 31, 2029

Study Completion (Estimated)

March 31, 2029

Study Registration Dates

First Submitted

August 19, 2026

First Submitted That Met QC Criteria

August 19, 2026

First Posted (Actual)

August 24, 2026

Study Record Updates

Last Update Posted (Actual)

August 24, 2026

Last Update Submitted That Met QC Criteria

August 19, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Other Study ID Numbers

  • 202606027

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.