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 journalArticle

10 Citations (Scopus)

Abstract

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
Volume90
Issue number1
DOIs
StatePublished - Jan 2013

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Early Detection of Cancer
Ethnic Groups
Colorectal Neoplasms
Language
Hispanic Americans
Occult Blood
Self Efficacy
Colonoscopy
Randomized Controlled Trials
Logistic Models
Psychology
Delivery of Health Care
Control Groups

Keywords

  • 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)

Cite this

Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups. / Jerant, Anthony F; Kravitz, Richard L; Fiscella, Kevin; Sohler, Nancy; Romero, Raquel Lozano; Parnes, Bennett; Aguilar-Gaxiola, Sergio; Turner, Charles; Dvorak, Simon; Franks, Peter.

In: Patient Education and Counseling, Vol. 90, No. 1, 01.2013, p. 103-110.

Research output: Contribution to journalArticle

Jerant, Anthony F ; Kravitz, Richard L ; Fiscella, Kevin ; Sohler, Nancy ; Romero, Raquel Lozano ; Parnes, Bennett ; Aguilar-Gaxiola, Sergio ; Turner, Charles ; Dvorak, Simon ; Franks, Peter. / Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups. In: Patient Education and Counseling. 2013 ; Vol. 90, No. 1. pp. 103-110.
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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.

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