Promoting colorectal cancer screening discussion: a randomized controlled trial

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

doi:10.1016/j.amepre.2012.11.032

Promoting colorectal cancer screening discussion: a randomized controlled trial

Am J Prev Med. 2013 Apr;44(4):325-329. doi: 10.1016/j.amepre.2012.11.032.

Authors

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

Affiliations

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.

Publication types

Comparative Study
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural

MeSH terms

Age Factors
Black or African American / statistics & numerical data
Colonoscopy / methods
Colorectal Neoplasms / diagnosis*
Computers
Female
Health Promotion / methods
Humans
Logistic Models
Male
Mass Screening / methods*
Middle Aged
Occult Blood
Pamphlets
Patient Compliance*
Physician-Patient Relations
Primary Health Care / organization & administration*
Self Efficacy
Social Support
Urban Health Services / organization & administration

Associated data

ClinicalTrials.gov/NCT00672828

Abstract

Publication types

MeSH terms

Associated data

Grants and funding