Sociopsychological Tailoring to Address Colorectal Cancer Screening Disparities: A Randomized Controlled Trial
| Autor: | Charles Turner, Kevin Fiscella, Simon Dvorak, Nancy L. Sohler, Bennett Parnes, Daniel J. Tancredi, Peter Franks, Richard L. Kravitz, Andrew Hudnut, Sergio Aguilar-Gaxiola, Anthony F Jerant, Christina Slee, Raquel L. Romero, Francisco Javier García Prieto |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Gerontology Health Knowledge Attitudes Practice health promotion Psychological intervention Ethnic group health care disparities Medical and Health Sciences law.invention health behavior Randomized controlled trial law Psychology Health belief model Medicine Health Education Sigmoidoscopy Early Detection of Cancer Cancer Original Research Practice medicine.diagnostic_test Health Knowledge Colonoscopy Hispanic or Latino Middle Aged Self Efficacy Colo-Rectal Cancer Studies in Human Society Occult Blood Female Health education Hispanic Americans Colorectal Neoplasms Family Practice Clinical Trials and Supportive Activities Health Promotion computer-assisted instruction Clinical Research General & Internal Medicine health education Humans Healthcare Disparities expanded health belief model Aged Self-efficacy software business.industry Prevention colorectal neoplasms outcome and process assessment patient acceptance of health care Good Health and Well Being Health promotion Attitudes randomized controlled trial Digestive Diseases business |
| Zdroj: | Annals of family medicine, vol 12, iss 3 |
| ISSN: | 1544-1717 1544-1709 |
| DOI: | 10.1370/afm.1623 |
| Popis: | PURPOSE Interventions tailored to sociopsychological factors associated with health behaviors have promise for reducing colorectal cancer screening dispari- ties, but limited research has assessed their impact in multiethnic populations. We examined whether an interactive multimedia computer program (IMCP) tai- lored 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, readi - ness, 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 (Sac - ramento, 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 sig- nificantly greater colorectal cancer screening knowledge, self-efficacy, readiness, test preference specificity, discussion, and recommendation. During the follow- up 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 multi- ethnic sample, despite enhancing sociopsychological factors and visit behaviors associated with screening. The utility of sociopsychological tailoring in address- ing screening disparities remains uncertain. |
| Databáze: | OpenAIRE |
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