Research articlePromoting Colorectal Cancer Screening Discussion: A Randomized Controlled Trial
Introduction
Tailored interventions are more effective than nontailored materials in promoting behavior change, including cancer screening.1, 2, 3, 4, 5 The current RCT compared the efficacy of a clinic-based, computer-delivered tailored interactive program with a nontailored brochure to promote patient–provider discussions about colorectal cancer (CRC) screening among African-American patients. Demographic, clinic, and health belief variables were examined as predictors of a discussion. CRC screening test orders written during the visit also were examined. It was hypothesized that (1) individuals who received the computer-delivered tailored intervention would be more likely to engage in CRC screening discussions with their primary care provider (PCP) than those in the brochure group and (2) PCPs of individuals who received the computer-delivered tailored intervention would be more likely to write orders for colon tests than PCPs of those in the brochure group.
Section snippets
Methods
A total of 693 African-American patients of 118 PCPs were enrolled between 2008 and 2010. Patients were eligible if they self-identified as black or African-American and were aged 51–80 years, English-speaking, and currently non-adherent to CRC screening guidelines. Exclusion criteria were personal history of CRC or adenomatous polyps requiring surveillance colonoscopy; medical condition precluding CRC screening; cognitive, speech, or hearing impairment; and current adherence to CRC screening
Results
Baseline demographic data are listed in Table 1. Of the 693 primary care patients who received interventions (319 in the computer group, 340 in the brochure group), 659 (95%) completed the 1 week post-intervention interview. Univariate analysis of intervention effects on patient–provider discussions is presented in Table 2. Compared to those who received the nontailored brochure, participants who received the computer-delivered tailored intervention were more likely to report having engaged in
Discussion
This study compared efficacy of two clinic-based interventions to stimulate patient-reported CRC screening discussions between African-American primary care patients and their PCPs. Individuals who received the computer-delivered tailored intervention had higher odds of reporting a colon test discussion with their PCP and were more likely to have a CRC screening test ordered during the visit. This study is novel because of its focus on evaluating efficacy of an interactive CRC screening
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