Nancy L Sohler1, Anthony Jerant2, Peter Franks3. 1. Community Health and Social Medicine, Sophie Davis School of Biomedical Education, City College of New York, New York, USA. Electronic address: nsohler@med.cuny.edu. 2. Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, USA. Electronic address: afjerant@ucdavis.edu. 3. Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, USA.
Abstract
OBJECTIVE: CRC screening interventions tailored to the Expanded Health Belief Model (EHBM) socio-psychological factors have been developed, but the contributions of individual factors to screening outcomes are unclear. METHODS: In observational analyses of data from a randomized intervention trial, we examined the independent associations of five EHBM factors - CRC screening knowledge, self-efficacy, stage of readiness, barriers, and discussion with a provider - with objectively measured CRC screening after one year. RESULTS: When all five factors were added simultaneously to a base model including other patient and visit characteristics, three of the factors were associated with CRC screening: self-efficacy (OR=1.32, p=0.001), readiness (OR=2.72, p<0.001), and discussion of screening with a provider (OR=1.59, p=0.009). Knowledge and barriers were not independently associated with screening. Adding the five socio-psychological factors to the base model improved prediction of CRC screening (area under the curve) by 7.7%. CONCLUSION: Patient CRC screening self-efficacy, readiness, and discussion with a provider each independently predicted subsequent screening. PRACTICE IMPLICATIONS: Self-efficacy and readiness measures might be helpful in parsimoniously predicting which patients are most likely to engage in CRC screening. The importance of screening discussion with a provider suggests the potential value of augmenting patient-focused EHBM-tailored interventions with provider-focused elements.
OBJECTIVE: CRC screening interventions tailored to the Expanded Health Belief Model (EHBM) socio-psychological factors have been developed, but the contributions of individual factors to screening outcomes are unclear. METHODS: In observational analyses of data from a randomized intervention trial, we examined the independent associations of five EHBM factors - CRC screening knowledge, self-efficacy, stage of readiness, barriers, and discussion with a provider - with objectively measured CRC screening after one year. RESULTS: When all five factors were added simultaneously to a base model including other patient and visit characteristics, three of the factors were associated with CRC screening: self-efficacy (OR=1.32, p=0.001), readiness (OR=2.72, p<0.001), and discussion of screening with a provider (OR=1.59, p=0.009). Knowledge and barriers were not independently associated with screening. Adding the five socio-psychological factors to the base model improved prediction of CRC screening (area under the curve) by 7.7%. CONCLUSION:Patient CRC screening self-efficacy, readiness, and discussion with a provider each independently predicted subsequent screening. PRACTICE IMPLICATIONS: Self-efficacy and readiness measures might be helpful in parsimoniously predicting which patients are most likely to engage in CRC screening. The importance of screening discussion with a provider suggests the potential value of augmenting patient-focused EHBM-tailored interventions with provider-focused elements.
Authors: Carrie N Klabunde; Paul S Frame; Ann Meadow; Elizabeth Jones; Marion Nadel; Sally W Vernon Journal: Prev Med Date: 2003-03 Impact factor: 4.018
Authors: Alfred C Marcus; Mondi Mason; Pam Wolfe; Barbara K Rimer; Isaac Lipkus; Victor Strecher; Richard Warneke; Marion E Morra; Amy Reasinger Allen; Sharon W Davis; Amy Gaier; Carlan Graves; Karen Julesberg; Lynne Nguyen; Rosemarie Perocchia; Jo Beth Speyer; Doug Wagner; Chris Thomsen; Mary Anne Bright Journal: J Health Commun Date: 2005
Authors: Shannon M Christy; Susan M Perkins; Yan Tong; Connie Krier; Victoria L Champion; Celette Sugg Skinner; Jeffrey K Springston; Thomas F Imperiale; Susan M Rawl Journal: Am J Prev Med Date: 2013-04 Impact factor: 5.043
Authors: Elizabeth A Rogers; Sunny Chanthanouvong; Chongchith Saengsudham; Vilamone Tran; Layne Anderson; Lei Zhang; Hee Yun Lee Journal: J Immigr Minor Health Date: 2020-04
Authors: Caroline R Jenkins; Matthew Rutledge; Lauren Hudson; Nathan L Vanderford; Nancy E Schoenberg Journal: J Cancer Educ Date: 2022-01-05 Impact factor: 2.037
Authors: Brooke T Nezami; Wei Lang; John M Jakicic; Kelliann K Davis; Kristen Polzien; Amy D Rickman; Karen E Hatley; Deborah F Tate Journal: Health Psychol Date: 2016-05-16 Impact factor: 4.267
Authors: Celette Sugg Skinner; Samir Gupta; Wendy Pechero Bishop; Chul Ahn; Jasmin A Tiro; Ethan A Halm; David Farrell; Emily Marks; Jay Morrow; Manjula Julka; Katharine McCallister; Joanne M Sanders; Susan M Rawl Journal: Prev Med Rep Date: 2016-04-30