Shannon M Christy1, Susan M Perkins2, Yan Tong2, Connie Krier3, Victoria L Champion3, Celette Sugg Skinner4, Jeffrey K Springston5, Thomas F Imperiale2, Susan M Rawl6. 1. Department of Psychology, Purdue School of Science, Indiana University-Purdue University Indianapolis, Indiana. 2. School of Medicine, Indiana University, Indianapolis, Indiana. 3. School of Nursing, Indiana University, Indianapolis, Indiana. 4. Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas. 5. College of Journalism and Mass Communication, University of Georgia, Athens, Georgia. 6. School of Nursing, Indiana University, Indianapolis, Indiana. Electronic address: srawl@iupui.edu.
Abstract
BACKGROUND: Provider recommendation is a predictor of colorectal cancer (CRC) screening. PURPOSE: To compare the effects of two clinic-based interventions on patient-provider discussions about CRC screening. DESIGN: Two-group RCT with data collected at baseline and 1 week post-intervention. SETTING/PARTICIPANTS: African-American patients that were non-adherent to CRC screening recommendations (n=693) with a primary care visit between 2008 and 2010 in one of 11 urban primary care clinics. INTERVENTION: Participants received either a computer-delivered tailored CRC screening intervention or a nontailored informational brochure about CRC screening immediately prior to their primary care visit. MAIN OUTCOME MEASURES: Between-group differences in odds of having had a CRC screening discussion about a colon test, with and without adjusting for demographic, clinic, health literacy, health belief, and social support variables, were examined as predictors of a CRC screening discussion using logistic regression. Intervention effects on CRC screening test order by PCPs were examined using logistic regression. Analyses were conducted in 2011 and 2012. RESULTS: Compared to the brochure group, greater proportions of those in the computer-delivered tailored intervention group reported having had a discussion with their provider about CRC screening (63% vs 48%, OR=1.81, p<0.001). Predictors of a discussion about CRC screening included computer group participation, younger age, reason for visit, being unmarried, colonoscopy self-efficacy, and family member/friend recommendation (all p-values <0.05). CONCLUSIONS: The computer-delivered tailored intervention was more effective than a nontailored brochure at stimulating patient-provider discussions about CRC screening. Those who received the computer-delivered intervention also were more likely to have a CRC screening test (fecal occult blood test or colonoscopy) ordered by their PCP. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT00672828.
RCT Entities:
BACKGROUND: Provider recommendation is a predictor of colorectal cancer (CRC) screening. PURPOSE: To compare the effects of two clinic-based interventions on patient-provider discussions about CRC screening. DESIGN: Two-group RCT with data collected at baseline and 1 week post-intervention. SETTING/PARTICIPANTS: African-American patients that were non-adherent to CRC screening recommendations (n=693) with a primary care visit between 2008 and 2010 in one of 11 urban primary care clinics. INTERVENTION: Participants received either a computer-delivered tailored CRC screening intervention or a nontailored informational brochure about CRC screening immediately prior to their primary care visit. MAIN OUTCOME MEASURES: Between-group differences in odds of having had a CRC screening discussion about a colon test, with and without adjusting for demographic, clinic, health literacy, health belief, and social support variables, were examined as predictors of a CRC screening discussion using logistic regression. Intervention effects on CRC screening test order by PCPs were examined using logistic regression. Analyses were conducted in 2011 and 2012. RESULTS: Compared to the brochure group, greater proportions of those in the computer-delivered tailored intervention group reported having had a discussion with their provider about CRC screening (63% vs 48%, OR=1.81, p<0.001). Predictors of a discussion about CRC screening included computer group participation, younger age, reason for visit, being unmarried, colonoscopy self-efficacy, and family member/friend recommendation (all p-values <0.05). CONCLUSIONS: The computer-delivered tailored intervention was more effective than a nontailored brochure at stimulating patient-provider discussions about CRC screening. Those who received the computer-delivered intervention also were more likely to have a CRC screening test (fecal occult blood test or colonoscopy) ordered by their PCP. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT00672828.
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