Colorectal cancer (CRC) is the second leading cause of cancer related death in the United States. In 2010, it is estimated that 142,570 cases of CRC will be diagnosed and the number of CRC deaths will equal 51,370. Most cases of CRC can be prevented by early screening and detection of precancerous polyps. Five year survival rate, if detected and treated early, is 91%. An estimated 30,000 to 44,000 lives a year could be saved if CRC screening is performed on all adults over the age of 50 years. Foreground: The impact of clinical educational counseling is important to improve compliance to CRC screening. Barriers must be understood and interventions developed to increase attainment of CRC screening. This project helped to define the level of education, attitudes, and stage of commitment are by the average risk patient age 50-65 years in a primary care setting before and after a clinical storytelling educational intervention regarding colorectal cancer and screening. Methods: Twenty-five average-risk patients agreed to participate in completion of a pre-intervention survey about CRC knowledge, attitudes, and stages of commitment toward attaining CRC screening. The participants were counseled about CRC and screening using a scripted storytelling education format and the use of an educational pamphlet. Six weeks later, a telephone interview took place to evaluate patient response to the counseling session and their stage of commitment to screening. A chart audit was then done 3 weeks later to determine whether screening took place. Descriptive statistics were performed to evaluate the data. EBP Framework: The framework for this capstone project was the Model for Evidence-Based Practice Change. The Theoretical foundation was based on the blended theory of (a) Imogene King’s Theory of Goal Attainment, and (b) Transtheoretical Model (TTM) of International Behavior Change. Findings/Results: The needs analysis prior to the project revealed 50% of patients were counseled to have screening, with only 16% receiving screening. After instituting the storytelling educational intervention, the rate of screening of the 25 participants was 56%. The stages of change at post-counseling were statistically significant toward positive movement in attainment of screening. The participants agreed to the readability and understanding of the pamphlet. The storytelling intervention was interesting, offered new information, and participants were able to relate personally with the story character. The reported stages of change at the 6-week follow-up were statistically significant with completed CRC screening. Those participants that completed screening were reported in the contemplation and or action stages. Conclusions/Recommendations: Movement toward a systematic utilization of clinical practice guidelines and the measurement of outcomes from the use of a storytelling educational intervention, supplemented with an informational pamphlet and the scheduling assistance by the office staff have facilitated patients to attain early colorectal cancer screening. A continuous monitoring plan has been developed to continue adherence to clinical practice guidelines for colorectal cancer screening.
