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No clinical systems in place to identify patients who need repeat screening, unless they present for care
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EHR query to identify patients due for repeat screening; outreach to patients (half randomized to intervention)
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No personal systems in place for patients to track when preventive services are due
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Automatic phone/text reminders to remind patients they are due for screening
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Low adherence to repeat screening because of financial and/or logistical barriers
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Mail FOBT kits to patients
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Patients forget to return FOBT
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Automatic phone/text reminders to patients who do not return FOBT within 2 weeks
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Low priority and/or risk perception for CRC
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Call from CRC Screening Coordinator at 3 months to patients who do not complete FOBT to explain need for screening
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Change of phone number and/or address makes initial reminders unsuccessful
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When CRC Screening Coordinator calls at 3 months, he can use updated information (i.e., from a recent visit)
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Patients do not understand instructions
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Mailed FOBT kits include plain language information, instructions, and direct phone number for CRC Screening Coordinator
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Lack of understanding of polyps, CRC, and recommendation for FOBT screening
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Call from CRC Screening Coordinator at 3 months to patients who do not complete FOBT to explain why they need repeat screening, answer questions, and mail another FOBT if requested; letter from CRC Screening Coordinator when FOBT results are negative to remind patients to repeat screening in 1–2 years and give due date
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