Background: Motivational interviewing (MI) is a technique to encourage behavior change but has not been used extensively in cancer screenings. MI can be used as an effective tool to encourage high risk veterans to uptake colorectal cancer (CRC) screening. MI is a low-cost effective tool that can be used to improve cancer screenings and population-level health outcomes. The transtheoretical model can help providers determine when cancer screening counseling would be most effective and who is most likely to adhere to screening.
Methods: Veterans were selected and contacted via telephone by a physician trained in motivational interviewing who counseled the individuals on the risks/benefits to colonoscopy and Fecal Immunochemical Testing (FIT). Per individual request, call-backs at intervals determined by the veterans were performed. Motivation was graded based on the transtheoretical model after each interaction. Veterans were tracked for 3 months after initial interview to see if they had been scheduled for CRC screening. Patient data were obtained through VA electronic medical record system (CPRS) query. Interview data were inputted into a customized template. Monthly queries were performed to track screening uptake of interview participants.
Results: Monthly queries via clinical informatics were performed to track veterans who had received the MI intervention. Based on pilot qualitative results, veterans have adequate knowledge of colonoscopies but are unaware of FIT to screen for CRC. Preliminary results have shown that veterans are more likely to uptake CRC screening after use of MI and speaking with a physician. Staging based on the transtheoretical model dictates the likelihood of scheduling a colonoscopy.
Conclusions: MI can be used as a tool to help veterans to uptake CRC screening and the transtheoretical model can be applied to determine the likelihood of veteran to undergo screening and perhaps future adherence.

Application of the transtheoretical model of change to colorectal cancer screening in high risk veterans

Consortium for Graduate Medical Education 13th Annual Resident Research Day

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