Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups

Anthony F Jerant, Richard L Kravitz, Kevin Fiscella, Nancy Sohler, Raquel Lozano Romero, Bennett Parnes, Sergio Aguilar-Gaxiola, Charles Turner, Simon Dvorak, Peter Franks

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: Tailoring to psychological constructs (e.g. self-efficacy, readiness) motivates behavior change, but whether knowledge tailoring alone changes healthcare preferences - a precursor of behavior change in some studies - is unknown. We examined this issue in secondary analyses from a randomized controlled trial of a tailored colorectal cancer (CRC) screening intervention, stratified by ethnicity/language subgroups (Hispanic/Spanish, Hispanic/English, non-Hispanic/English). Methods: Logistic regressions compared effects of a CRC screening knowledge-tailored intervention versus a non-tailored control on preferences for specific test options (fecal occult blood or colonoscopy), in the entire sample (N=1164) and the three ethnicity/language subgroups. Results: Pre-intervention, preferences for specific tests did not differ significantly between study groups (experimental, 64.5%; control 62.6%). Post-intervention, more experimental participants (78.6%) than control participants (67.7%) preferred specific tests (P<0.001). Adjusting for pre-intervention preferences, more experimental group participants than control group participants preferred specific tests post-intervention [average marginal effect (AME)=9.5%, 95% CI 5.3-13.6; P<0.001]. AMEs were similar across ethnicity/language subgroups. Conclusion: Knowledge tailoring increased preferences for specific CRC screening tests across ethnic and language groups. Practice Implications: If the observed preference changes are found to translate into behavior changes, then knowledge tailoring alone may enhance healthy behaviors.

Original languageEnglish (US)
Pages (from-to)103-110
Number of pages8
JournalPatient Education and Counseling
Issue number1
StatePublished - Jan 2013


  • Attitudes, and practices
  • Colonoscopy
  • Colorectal neoplasms/diagnosis
  • Computer-assisted instruction/methods
  • Health behavior
  • Health knowledge
  • Healthcare disparities
  • Hispanic Americans
  • Language
  • Mass screening
  • Multicenter study
  • Multimedia
  • Occult blood
  • Patient acceptance of health care
  • Patient education as topic/methods
  • Patient preference

ASJC Scopus subject areas

  • Medicine(all)


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