Race and response to colon cancer screening interventions.
OBJECTIVE
We report race-related differences in response to behavioral interventions in colorectal cancer (CRC) screening.


METHODS
From 2002 through 2005, a total of 1430 primary care patients (578 whites and 852 African Americans) from Jefferson Family Medicine Associates, a large primary care practice affiliated with Thomas Jefferson University, completed a baseline survey and were randomized to 1 of 4 groups, as follows: control (usual care), standard intervention (SI), tailored intervention (TI), or tailored intervention plus phone (TIP). The SI group received a targeted print intervention by mail. The TI group received the targeted intervention and tailored message pages that addressed perceptions related to screening. The TIP group received the targeted intervention, tailored message pages, and a telephone reminder.


RESULTS
CRC screening rates for whites and African Americans were comparable in usual care (33% versus 32%, respectively). In response to intervention, however, whites exhibited significantly higher (p=0.005) screening rates than African Americans (53% versus 43%, respectively; adjusted OR=1.44; 95% CI=1.12-1.86). This effect is largely explained by differential response to mailed print interventions.


CONCLUSIONS
Whites and African Americans may respond differently to mailed interventions intended to increase CRC screening. Research is needed on methods that can both increase screening and racial equity in screening.
Thomas Jefferson University, Division of Gastroenterology, Department of Internal Medicine, Philadelphia, PA 19107, USA. ali.siddiqui@jefferson.edu
Ali A
AA
Siddiqui
Randa
R
Sifri
Terry
T
Hyslop
Jocelyn
J
Andrel
Michael
M
Rosenthal
Sally W
SW
Vernon
James
J
Cocroft
Ronald E
RE
Myers
D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D015143:Philadelphia; D011177:Postal Service; D017010:Reminder Systems; D013689:Telephone; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data