Table 1 PRECIS assessment of the STIC study

Participant eligibility criteria

Eligible participants will include all physicians performing outpatient colonoscopy regardless of specialty, all staff providing bowel preparation education to patients before outpatient colonoscopy, and all patients scheduled for outpatient colonoscopy regardless of whether they are scheduled for a screening or diagnostic procedure.

Experimental intervention—flexibility

The experimental condition will allow for flexibility in the timing of staff delivering the intervention to patients so that the EBPs are integrated into existing processes as seamlessly as possible. However, staff may be provided with recommendations for the timing of intervention delivery to patients.

Experimental intervention—practitioner expertise

All physicians and staff members will be involved regardless of specialization, level of training, or expertise.

Comparison intervention(s)—flexibility

Physicians will receive an education module, but physicians’ staff members will be assigned to usual practice.

Comparison intervention(s)—practitioner expertise

All physicians and staff members will be involved regardless of specialization, level of training, or expertise.

Follow-up intensity

To boost the response rate above, initial mailings will include contacts from our strategic partners, and study staff will follow up weekly with email reminders and phone calls to non-respondents. After enrollment, no contact is made with physicians or staff.

Primary trial outcome

Primary outcomes will include both an intermediate implementation outcome (i.e., EBP adoption) and more long-range clinical outcomes (i.e., bowel preparation, adenoma detection). The outcomes, particularly the clinical outcomes, are well-specified, clinically meaningful, and assessed under usual conditions.

Participant compliance with intervention

Physician participation in the education module and provision of staff names, as well as staff participation rates for each component of the toolkit (i.e., education module, website, ordering materials, brief consultation) will be measured through Google Analytics and Qualtrics primarily for descriptive purposes and to inform improvement of the toolkit in future studies. No other compliance-improving strategies will be applied in this study.

Practitioner adherence to study protocol

The provision of teach-back and low-literacy education to patients will be measured and assessed but not fed back to staff or physicians during the course of the study. No ongoing data feedback or other adherence-improving strategies will be applied in this study.

Analysis of primary outcome

The segmented regression analysis of interrupted time series data (SRAITSD) will maximize external validity by informing the generalizability of effects across endoscopy settings and insurance strata.