NCT06401174

Brief Summary

Patient navigation is an evidence-based strategy to increase screening rates among racial and ethnic minorities, but there is a gap in understanding the multi-level influences on implementation of such programs across primary care practices. The investigators will conduct a stepped-wedge, randomized trial to roll out patient navigation and patient and provider reminders across 15 clinics (3 clinics per step, 5 six-month steps). Implementation strategies will include assessing for readiness, audit and feedback, building a community coalition, engaging consumers, modifying referral tracking, and training and educating clinical stakeholders. The research team will use the electronic health record data with consideration for the Observational Medical Outcomes Partnership (OMOP) Common Data Model, additional patient-reported data, and study tracking logs to measure reach, effectiveness, adoption, implementation, and will use qualitative measures and site observations to document contextual factors, including examination of discrimination in patient experiences and provider referral patterns that may influence intervention delivery or colorectal cancer screening completion.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,800

participants targeted

Target at P75+ for not_applicable

Timeline
27mo left

Started Jun 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

15 active sites

Status
enrolling by invitation

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress46%
Jun 2024Jul 2028

First Submitted

Initial submission to the registry

April 22, 2024

Completed
14 days until next milestone

First Posted

Study publicly available on registry

May 6, 2024

Completed
26 days until next milestone

Study Start

First participant enrolled

June 1, 2024

Completed
3.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 30, 2028

Expected
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

July 30, 2028

Last Updated

October 22, 2025

Status Verified

October 1, 2025

Enrollment Period

3.7 years

First QC Date

April 22, 2024

Last Update Submit

October 20, 2025

Conditions

Keywords

disparitiesPatient navigation

Outcome Measures

Primary Outcomes (1)

  • Colorectal cancer screening completion

    Completion of any USPSTF approved screening test

    12 months

Secondary Outcomes (6)

  • Reach

    6 months

  • Adoption

    6 months

  • Acceptability measured by the Acceptability of Intervention Measure (AIM)

    12 months

  • Appropriateness measured by the Intervention Appropriateness Measure (IAM)

    12 months

  • Feasibility measured by the Feasibility of Implementation Measure (FIM)

    12 months

  • +1 more secondary outcomes

Study Arms (2)

Patient navigation

EXPERIMENTAL

Patient navigation will be rolled out at the clinic level (15 clinics). Referral orders will become available to participating clinics, with education and audit and feedback for providers. The study team will tailor patient navigation supports by clinic site for specifics on how the intervention is delivered.

Behavioral: Delivery of patient navigation

Usual care

NO INTERVENTION

Interventions

Clinics will receive educational materials and access a referral order for patient navigation. Iterative strategies will be used to increase CRC screening

Patient navigation

Eligibility Criteria

Age45 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age 45-75
  • Due for colorectal cancer screening
  • Identify as Black or Hispanic/Latino
  • Attend primary care visit at one of the 15 selected clinics within the step time -period

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (15)

Internal Medicine Wisconsin Avenue

Washington D.C., District of Columbia, 20007, United States

Location

Family Medicine Spring Valley

Washington D.C., District of Columbia, 20016, United States

Location

Primary Care Lafayette

Washington D.C., District of Columbia, 20036, United States

Location

Family Medicine Fort Lincoln

Washington D.C., District of Columbia, 20722, United States

Location

Honeygo

Baltimore, Maryland, 21128, United States

Location

MedStar Adult Medicine at Union Memorial

Baltimore, Maryland, 21218, United States

Location

Harbor Hospital Primary Care Federal Hill

Baltimore, Maryland, 21230, United States

Location

Franklin Square

Baltimore, Maryland, 21237, United States

Location

Primary Care at Franklin Square

Baltimore, Maryland, 21237, United States

Location

Charlotte Hall

Charlotte Hall, Maryland, 20622, United States

Location

Internal Medicine Clinton

Clinton, Maryland, 20735, United States

Location

Family Medicine

Gaithersburg, Maryland, 20878, United States

Location

Internal Medicine Hyattsville

Hyattsville, Maryland, 20782, United States

Location

Family Medicine

Olney, Maryland, 20832, United States

Location

Olney Prof Park

Olney, Maryland, 20832, United States

Location

Related Publications (1)

  • Rivera Rivera JN, AuBuchon KE, Schubel LC, Starling C, Tran J, Locke M, Grady M, Mete M, Blumenthal HJ, Galarraga JE, Arem H. Supporting ColoREctal Equitable Navigation (SCREEN): a protocol for a stepped-wedge cluster randomized trial for patient navigation in primary care. Implement Sci Commun. 2024 Jun 3;5(1):60. doi: 10.1186/s43058-024-00598-5.

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
SCREENING
Intervention Model
SEQUENTIAL
Model Details: Step wedge trial with 5 six-month steps, three clinics at a time, for a total of 15 clinics.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 22, 2024

First Posted

May 6, 2024

Study Start

June 1, 2024

Primary Completion (Estimated)

January 30, 2028

Study Completion (Estimated)

July 30, 2028

Last Updated

October 22, 2025

Record last verified: 2025-10

Data Sharing

IPD Sharing
Will not share

Locations