Improvement of participation rate in colo-rectal cancer (CRC) screening by training general practitioners in motivational interviewing (AmDepCCR)

Paul Aujoulat, Delphine Le Goff, Gabriel Perraud, Jean-Baptiste Nousbaum, Michel Robaszkiewicz, Morgane Guillou-Landreat, Jean Yves Le Reste

Keywords: CRC Screening; Early Detection; Motivational Interviewing; Psychological Approach; Professional-Patient relations; Primary Care; Study Protocol

Background:
Colo-rectal cancer (CRC) is the second leading cause of cancer death in France (17,712 annual deaths). However, this cancer is preventable in the majority of cases by the early detection of adenomas. In France the organized screening for CRC relies on general practitioners (GPs). The tests delivered by the GPs are carried out in 89% of cases. However, GPs do not systematically offer the test, because of time management and communication.

Research questions:
Is training GPs in motivational interviewing effective to increase the OS CRC participation rate of at least 10 percent ?

Method:
AmDepCCR is a cluster randomized trial. Patients are prospectively included by their GPs. The study is designed in 2 phases for the GPs: first, GPs who have never participated in motivational interviewing (MI) training, will be recruited then randomly split in 2 groups. Secondly, a 6-day motivational interviewing training will be carried out for the intervention group. Then, patients will be included in both groups during a period of 1 year. The primary outcome will be the number of CRC screenings achieved in each group and its difference. The secondary outcome will be the reluctance to screening and the patient's self-estimated life expectancy at 0, 6, 12 and 24 months using the Health Belief Model (HBM).

Results:
Inclusion started in June, 2021. Complete results will be available in 2024.

Conclusions:

Points for discussion: