P2128 - Optimizing Colorectal Cancer Screening: Effective FIT Distribution and Follow-Up Strategies in the ACCESS Program

Abraham A. Ifrah, MD, MS¹, Christopher Grivas, MD, MBA¹, Shelby McNeilly, DO², Gabrielle Gillow, MD¹, Brianna Graham, MD¹, Nikita Dahake, MD², Manasa Vallabhaneni, MD¹, Samyuktha Manikandan, MD¹, Rishabh Khatri, MD¹, Claire Raab, MD^3
1Temple University Hospital, Philadelphia, PA; ²Temple University, Philadelphia, PA; ³Temple Health, Philadelphia, PA

Introduction: The ACCESS program distributes fecal immunochemical tests (FIT) directly to the community and ensures follow-up. This study seeks to determine the optimal times for patient engagement in post-FIT test navigation to address disparities in colorectal cancer screening.





Methods: Patients were given FIT tests at various events and instructed to contact us after they completed the FIT test at home. If patients did not contact us, they were contacted once weekly, three times by text and once by phone. Those not responding after four attempts were marked as incomplete.

Results: 57% of patients responded to the follow up protocol. 23% initiated contact with us (C0),40% responded to our first contact (C1), 17% responded to contact 2 (C2), 13% to contact 3 (C3) and 8% to contact 4 (C4).



10% of respondents had a positive result. The majority of these contacted us initially (37%) and otherwise had an equal likelihood of responding to the first three contacts (19%,19% and 22% respectively) but appeared much less likely to respond to C4 (4%).



72% of respondents had a negative result. Most of these patients responded to C1 (52%). This was followed by an equal likelihood to C0 and C2 (18% and 17%) followed by an equal likelihood to respond to C3 or C4 (7% and 6% ).



16% of respondents lost their FIT test. In descending order, C0 (38%) followed by C3,C2,C4 and C1 (31%,17%,10% and 5%). These results are summarized in Table 1.

Discussion: Our study assessed patient responsiveness to follow-up contacts after distributing at-home fecal immunochemical tests (FIT) via the ACCESS program. Responses decreased significantly on the fourth contact attempt, indicating reduced effectiveness of extended follow-up. We observed a 57% engagement rate, with distinct response patterns based on FIT results. Patients with positive results were more likely to initiate contact and responded equally to the first three text messages, highlighting the importance of multiple outreach attempts. Conversely, those with negative results were more likely to require outreach and were most responsive to the initial and second contact attempts. These findings emphasize the importance of multiple contacts and specifically the first three text messages in optimizing engagement, especially for identifying and supporting positive patients and providing them with expedited GI appointments. Distributing FIT tests effectively captures positive results through structured follow-up, demonstrating our program's efficacy in identifying positive cases.


Disclosures:


Abraham A. Ifrah, MD, MS¹, Christopher Grivas, MD, MBA¹, Shelby McNeilly, DO², Gabrielle Gillow, MD¹, Brianna Graham, MD¹, Nikita Dahake, MD², Manasa Vallabhaneni, MD¹, Samyuktha Manikandan, MD¹, Rishabh Khatri, MD¹, Claire Raab, MD³. P2128 - Optimizing Colorectal Cancer Screening: Effective FIT Distribution and Follow-Up Strategies in the ACCESS Program, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.