Effects of a tailored interactive multimedia computer program on determinants of colorectal cancer screening: a randomized controlled pilot study in physician offices.
OBJECTIVE
Screening reduces colorectal cancer (CRC) mortality and is cost-effective, yet uptake is suboptimal. We developed and evaluated a personally tailored interactive multimedia computer program (IMCP) to encourage CRC screening.


METHODS
Randomized controlled pilot trial evaluating the effects of the personally tailored CRC screening IMCP as compared with a non-tailored IMCP ("electronic leaflet") control. The IMCP was tailored to patient preference, self-efficacy, barriers, and readiness and deployed in busy primary care offices before scheduled doctor visits. Main outcomes were: CRC screening knowledge, self-efficacy, benefits and barriers, and stage of readiness.


RESULTS
We enrolled 54 subjects; software glitches occurred in 5, leaving 49 subjects for analysis. In adjusted analyses, compared with control, the experimental group had a significant increase in CRC screening self-efficacy (p=0.049), a significantly greater likelihood of moving to a more advanced stage of readiness for screening (p=0.034), a trend toward fewer perceived barriers to screening (p=0.149), and no difference in perceived benefits or knowledge of screening.


CONCLUSIONS
Our personally tailored IMCP was significantly more effective than control in bolstering CRC screening readiness and self-efficacy.


CONCLUSIONS
If further streamlined, personally tailored IMCPs might be usefully deployed in busy primary care offices to improve uptake of CRC screening.
Jerant
Anthony
A
Department of Family and Community Medicine (DF&CM), University of California Davis (UCD) School of Medicine (SOM), 4860 Y Street, Suite 2300, Sacramento, CA 95817, United States. afjerant@ucdavis.edu
Kravitz
Richard L
RL
Rooney
Mairin
M
Amerson
Scott
S
Kreuter
Matthew
M
Franks
Peter
P
D000465:Algorithms; D002140:California; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003194:Computer-Assisted Instruction / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D019212:Multimedia; D020380:Needs Assessment; D009819:Office Visits; D010174:Pamphlets; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D010347:Patient Care Planning / Q000458:organization & administration; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011320:Primary Health Care / Q000458:organization & administration; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013664:Teaching Materials