TY - JOUR
T1 - Sociopsychological tailoring to address colorectal cancer screening disparities
T2 - A randomized controlled trial
AU - Jerant, Anthony
AU - Kravitz, Richard L.
AU - Sohler, Nancy
AU - Fiscella, Kevin
AU - Romero, Raquel L.
AU - Parnes, Bennett
AU - Tancredi, Daniel J.
AU - Aguilar-Gaxiola, Sergio
AU - Slee, Christina
AU - Dvorak, Simon
AU - Turner, Charles
AU - Hudnut, Andrew
AU - Prieto, Francisco
AU - Franks, Peter
PY - 2014/1/1
Y1 - 2014/1/1
N2 - Purpose: Interventions tailored to sociopsychological factors associated with health behaviors have promise for reducing colorectal cancer screening disparities, but limited research has assessed their impact in multiethnic populations. We examined whether an interactive multimedia computer program (IMCP) tailored to expanded health belief model sociopsychological factors could promote colorectal cancer screening in a multiethnic sample. Methods: We undertook a randomized controlled trial, comparing an IMCP tailored to colorectal cancer screening self-efficacy, knowledge, barriers, readiness, test preference, and experiences with a nontailored informational program, both delivered before office visits. The primary outcome was record-documented colorectal cancer screening during a 12-month follow-up period. Secondary outcomes included postvisit sociopsychological factor status and discussion, as well as clinician recommendation of screening during office visits. We enrolled 1,164 patients stratified by ethnicity and language (49.3% non-Hispanic, 27.2% Hispanic/English, 23.4% Hispanic/Spanish) from 26 offices around 5 centers (Sacramento, California; Rochester and the Bronx, New York; Denver, Colorado; and San Antonio, Texas). Results: Adjusting for ethnicity/language, study center, and the previsit value of the dependent variable, compared with control patients, the IMCP led to significantly greater colorectal cancer screening knowledge, self-efficacy, readiness, test preference specificity, discussion, and recommendation. During the followup period, 132 (23%) IMCP and 123 (22%) control patients received screening (adjusted difference = 0.5 percentage points, 95% CI -4.3 to 5.3). IMCP effects did not differ significantly by ethnicity/language. Conclusions: Sociopsychological factor tailoring was no more effective than nontailored information in encouraging colorectal cancer screening in a multiethnic sample, despite enhancing sociopsychological factors and visit behaviors associated with screening. The utility of sociopsychological tailoring in addressing screening disparities remains uncertain.
AB - Purpose: Interventions tailored to sociopsychological factors associated with health behaviors have promise for reducing colorectal cancer screening disparities, but limited research has assessed their impact in multiethnic populations. We examined whether an interactive multimedia computer program (IMCP) tailored to expanded health belief model sociopsychological factors could promote colorectal cancer screening in a multiethnic sample. Methods: We undertook a randomized controlled trial, comparing an IMCP tailored to colorectal cancer screening self-efficacy, knowledge, barriers, readiness, test preference, and experiences with a nontailored informational program, both delivered before office visits. The primary outcome was record-documented colorectal cancer screening during a 12-month follow-up period. Secondary outcomes included postvisit sociopsychological factor status and discussion, as well as clinician recommendation of screening during office visits. We enrolled 1,164 patients stratified by ethnicity and language (49.3% non-Hispanic, 27.2% Hispanic/English, 23.4% Hispanic/Spanish) from 26 offices around 5 centers (Sacramento, California; Rochester and the Bronx, New York; Denver, Colorado; and San Antonio, Texas). Results: Adjusting for ethnicity/language, study center, and the previsit value of the dependent variable, compared with control patients, the IMCP led to significantly greater colorectal cancer screening knowledge, self-efficacy, readiness, test preference specificity, discussion, and recommendation. During the followup period, 132 (23%) IMCP and 123 (22%) control patients received screening (adjusted difference = 0.5 percentage points, 95% CI -4.3 to 5.3). IMCP effects did not differ significantly by ethnicity/language. Conclusions: Sociopsychological factor tailoring was no more effective than nontailored information in encouraging colorectal cancer screening in a multiethnic sample, despite enhancing sociopsychological factors and visit behaviors associated with screening. The utility of sociopsychological tailoring in addressing screening disparities remains uncertain.
KW - Colorectal neoplasms
KW - Computer-assisted instruction
KW - Early detection of cancer
KW - Expanded health belief model
KW - Health behavior
KW - Health care disparities
KW - Health education
KW - Health promotion
KW - Hispanic Americans
KW - Outcome and process assessment (health care)
KW - Patient acceptance of health care
KW - Randomized controlled trial
KW - Software
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UR - http://www.scopus.com/inward/citedby.url?scp=84900435222&partnerID=8YFLogxK
U2 - 10.1370/afm.1623
DO - 10.1370/afm.1623
M3 - Article
C2 - 24821891
AN - SCOPUS:84900435222
VL - 12
SP - 204
EP - 214
JO - Annals of Family Medicine
JF - Annals of Family Medicine
SN - 1544-1709
IS - 3
ER -