1. Phase II: Targeting Non-Adherence with Colorectal Cancer Pre- Screening Appointments and Colonoscopies using Nurse Navigation, Gretchen Junko DO, Gabriel McCoy DO, Meenu Jindal MD, Mark O’Rourke MD, Matthew Hudson PhD, MPH, Myah Griffin MS4, Kerolos Rizk DO Greenville Health System, Department of Internal Medicine, Greenville SC Aim  Problem: internal medicine resident clinic no show rate for colorectal screening “pre- colonoscopy” appointments was 28.17% from June, 2014 through June, 2015.  Purpose: to decrease non-adherence with colorectal cancer screening “pre- colonoscopy” appointments from 28% to 80% compliance with scheduled colonoscopies Introduction  Colorectal cancer was expected to cause 49,700 deaths in 2015 with a projected 132,700 newly diagnosed cases. 1  It is the third most common cancer in men and women along with the third leading cause of cancer deaths in the United States. 2,3  Colorectal cancer screening can prevent cancer by identifying and removing pre- cancerous growths and reduce colorectal cancer mortality by early detection and treatment.  The Centers for Disease Control and Prevention and U.S Preventive Services Task Force note that regular screening for colorectal cancer can decrease the mortality rate by up to 60%. 4  Lay navigators have been shown to be effective in increasing cancer screening of groups with disparities and in underserved communities. 6 Phase I of Study (Completed)  Identified leading reasons for missed colorectal cancer screening “pre-colonoscopy” appointments within the resident clinic via a telephone survey: Phase II of Study (In Progress)  Phase II will address the top two reasons (“forgot appointment” and “lack of a reminder”) for missed colorectal cancer screening “pre-colonoscopy” appointments by using a nurse navigator to make additional pre-appointment reminder phone calls to a randomized sect of patients. Our goal is to decrease non-adherence with colorectal cancer screening appointments from 28% to 80% compliance with scheduled colonoscopies. Methods:  Randomized control trial including two groups  All patients will receive a reminder phone call prior to pre-colonoscopy appointment  Randomized group of patients will receive additional reminder phone calls/educational call from nurse navigator Results/Plan:  IRB in progress  Execute randomized control trial  Track results of adherence to pre-colorectal screening appointments and scheduled colonoscopies using RedCap system © References 1.What Are the Key Statistics About Colorectal Cancer? The American Cancer Society. [Online] February 27, 2015. [Cited: July 31,2015]. 2. Cancer Statistics 2015. American Cancer Soceity. [Online] 2015. [Cited: July 31,2015] http://www.cancer.org/research/cancerfactsstastistics/cancerfactsfigures2015/index. http://www.cancer.org/research/cancerfactsstastistics/cancerfactsfigures2015/index 3.Colorectal Cancer Statistics. Centers for Disease Control and Prevention. [Online] September 2, 2014. [Cited: July 31, 2015] http://www.cdc.gov/cancer/colorectal/statistics/index.htm. http://www.cdc.gov/cancer/colorectal/statistics/index.htm 4.Preventing Chronic Diseases: Investing Wisely in Health, Screening to Prevent Cancer Deaths. [Online] Centers for Disease Control and Prevention and U.S Department of Health and Human Services, August 2008 [Cited: July 31, 2015]. http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/cancer.pdf. http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/cancer.pdf 5.Colorectal Cancer Facts and Figures 2014-2016. American Cancer Society. [Online] 2014. [Cited: July 31, 2015] http://www.cancer.org/acs/groups/content/documents/document/ascpc- 042280.pdf 6.Reducing Cancer Screening Disparities in Medicare Beneficiaries Through Cancer Patient Navigation Kathryn L. Braun DrPH1,2,*, William L. Thomas Jr MD3, Jermy- Leigh B. Domingo MPH2, J Am Geriatr Soc 63:365–370, 2015. Conclusion Goals:  Decrease non-adherence with colorectal cancer screening “pre-colonoscopy” appointments from 28% to <5%  >80% compliance with scheduled colonoscopy appointments