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Table 5 Outline of study protocol forms and surveys and anticipated number of responses

From: Does access to a colorectal cancer screening website and/or a nurse-managed telephone help line provided to patients by their family physician increase fecal occult blood test uptake?: A pragmatic cluster randomized controlled trial study protocol

Study protocol form/survey Individual completing form/survey Information obtained Anticipated number of responses
Clinic Characterization Form1 Medical Cluster and Family Physician Standard FOBT practice; Electronic medical record; on-site lab; solo/group practice 50 to 80
Family Physician Survey2 Family Physician Experience with study protocol and value to clinical practice; facilitators and barriers to study collaboration; interest in future community-based primary healthcare research projects 50 to 80
FOBT Completion Status Form Family Physician Patient FOBT status four months post requisition) 50 to 80
Patient Tracking Form3 Family Physician Date of FOBT requisition; Patient name; FOBT kit distribution method 1,500 to 2,400
In-Clinic Patient Survey4 Patient Age, gender, postal code, Previous FOBT screening history, internet use for health related questions; exposure to advertisements related to FOBT screening; consent for Post-Study Follow-Up Survey 1,500 to 2,400
Post Study Follow-Up Survey (control)5 Patient (10 patients per family physician) Colorectal cancer screening and FOBT experience with family physician; FOBT test instructions; computer access frequency of use; facilitators and barriers to completing the FOBT; Personal Health Information Number 250 to 400
Post Study Follow-Up Survey (intervention)6 Patient (10 patients per family physician) Colorectal cancer screening and FOBT experience with family physician; FOBT test instructions; computer access frequency of use; facilitators and barriers to completing the FOBT; experience with and usefulness of patient decision aids (telephone-support line and website); Personal Health Information Number 250 to 400
  1. 1, 2, 3, 4, 5, 6 Additional files 2, 11, 3, 6, 4 and 5 for each form and survey.