PURPOSE: To determine how often primary care physicians address patient-level health behavioral constructs that are associated with colorectal cancer (CRC) screening and whether physician counseling addressing constructs is associated with favorable changes in patients' attitudes, beliefs, intentions, and subsequent screening. METHODS: We conducted a prospective cohort study of patients eligible for CRC screening and attending routine appointments within two academic primary care clinics (50 patients, 20 primary care clinicians). Patients completed validated measures of behavioral constructs associated with CRC screening (benefits, barriers, susceptibility, self-efficacy, intention, and stage of readiness) before and after their visits. Audio-recorded discussions of CRC screening were coded for conversation addressing constructs. Bivariate and regression analyses estimated associations between discussions that did and did not address constructs and, after the visit, measures of perceived benefits, barriers, susceptibility, self-efficacy, intention, and completion of CRC screening within 6 months. RESULTS: Physicians discussed CRC screening during 38 encounters (76%) and addressed behavioral constructs during 26 (52%). Relative to visits without CRC screening discussion, visits with discussion were associated with increased perceived susceptibility (β = 0.39; 95% CI, 0.09-0.68) and screening intention (β = 0.42; 95% CI, 0.11-0.73) after the visit but no significant change in perceived benefits, barriers, or self-efficacy. Within 6 months, 17 of 38 patients (45%) who discussed screening completed screening compared with 0 of 12 patients who did not discuss screening (P = .001). Associations between discussions and outcomes were similar whether or not counseling addressed behavioral constructs. CONCLUSIONS: These findings suggest that physician counseling is associated with increased patient perception of CRC susceptibility, greater screening intention, and completion of screening regardless of whether counseling addresses behavioral constructs.
PURPOSE: To determine how often primary care physicians address patient-level health behavioral constructs that are associated with colorectal cancer (CRC) screening and whether physician counseling addressing constructs is associated with favorable changes in patients' attitudes, beliefs, intentions, and subsequent screening. METHODS: We conducted a prospective cohort study of patients eligible for CRC screening and attending routine appointments within two academic primary care clinics (50 patients, 20 primary care clinicians). Patients completed validated measures of behavioral constructs associated with CRC screening (benefits, barriers, susceptibility, self-efficacy, intention, and stage of readiness) before and after their visits. Audio-recorded discussions of CRC screening were coded for conversation addressing constructs. Bivariate and regression analyses estimated associations between discussions that did and did not address constructs and, after the visit, measures of perceived benefits, barriers, susceptibility, self-efficacy, intention, and completion of CRC screening within 6 months. RESULTS: Physicians discussed CRC screening during 38 encounters (76%) and addressed behavioral constructs during 26 (52%). Relative to visits without CRC screening discussion, visits with discussion were associated with increased perceived susceptibility (β = 0.39; 95% CI, 0.09-0.68) and screening intention (β = 0.42; 95% CI, 0.11-0.73) after the visit but no significant change in perceived benefits, barriers, or self-efficacy. Within 6 months, 17 of 38 patients (45%) who discussed screening completed screening compared with 0 of 12 patients who did not discuss screening (P = .001). Associations between discussions and outcomes were similar whether or not counseling addressed behavioral constructs. CONCLUSIONS: These findings suggest that physician counseling is associated with increased patient perception of CRC susceptibility, greater screening intention, and completion of screening regardless of whether counseling addresses behavioral constructs.
Authors: Jennifer Elston Lafata; Tracy Wunderlich; Susan A Flocke; Nancy Oja-Tebbe; Karen E Dyer; Laura A Siminoff Journal: Transl Behav Med Date: 2015-03 Impact factor: 3.046
Authors: Anthony Jerant; Richard L Kravitz; Nancy Sohler; Kevin Fiscella; Raquel L Romero; Bennett Parnes; Daniel J Tancredi; Sergio Aguilar-Gaxiola; Christina Slee; Simon Dvorak; Charles Turner; Andrew Hudnut; Francisco Prieto; Peter Franks Journal: Ann Fam Med Date: 2014 May-Jun Impact factor: 5.166
Authors: Jennifer Elston Lafata; Deirdre A Shires; Yongyun Shin; Susan Flocke; Kenneth Resnicow; Morgan Johnson; Ellen Nixon; Xinxin Sun; Sarah Hawley Journal: Med Decis Making Date: 2022-06-28 Impact factor: 2.749
Authors: Lara A Rosenwasser; Jennifer S McCall-Hosenfeld; Carol S Weisman; Marianne M Hillemeier; Amanda N Perry; Cynthia H Chuang Journal: Rural Remote Health Date: 2013-10-08 Impact factor: 1.759
Authors: Anthony Jerant; Brent Hanson; Richard L Kravitz; Daniel J Tancredi; Emily Hanes; Sanjeet Grewal; Rimaben Cabrera; Peter Franks Journal: Patient Educ Couns Date: 2016-08-22
Authors: Christine E Kistler; Thomas M Hess; Kirsten Howard; Michael P Pignone; Trisha M Crutchfield; Sarah T Hawley; Alison T Brenner; Kimberly T Ward; Carmen L Lewis Journal: Patient Prefer Adherence Date: 2015-07-15 Impact factor: 2.711