TY - JOUR
T1 - Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups
AU - Jerant, Anthony F
AU - Kravitz, Richard L
AU - Fiscella, Kevin
AU - Sohler, Nancy
AU - Romero, Raquel Lozano
AU - Parnes, Bennett
AU - Aguilar-Gaxiola, Sergio
AU - Turner, Charles
AU - Dvorak, Simon
AU - Franks, Peter
PY - 2013/1
Y1 - 2013/1
N2 - 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.
AB - 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.
KW - Attitudes, and practices
KW - Colonoscopy
KW - Colorectal neoplasms/diagnosis
KW - Computer-assisted instruction/methods
KW - Health behavior
KW - Health knowledge
KW - Healthcare disparities
KW - Hispanic Americans
KW - Language
KW - Mass screening
KW - Multicenter study
KW - Multimedia
KW - Occult blood
KW - Patient acceptance of health care
KW - Patient education as topic/methods
KW - Patient preference
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UR - http://www.scopus.com/inward/citedby.url?scp=84870789076&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2012.08.017
DO - 10.1016/j.pec.2012.08.017
M3 - Article
C2 - 22985627
AN - SCOPUS:84870789076
VL - 90
SP - 103
EP - 110
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 1
ER -