title: Patient activation increases colorectal cancer screening rates: a randomized trial among low-income minority patients.
abstract: BACKGROUND
  Colorectal cancer (CRC) screening rates remain low among low-income and minority populations. The purpose of this study was to determine whether providing patients with screening information, activating them to ask for a screening test, and telephone barriers counseling improves CRC screening rates compared with providing screening information only.
  
  
  METHODS
  Patients were randomized to CRC screening information plus patient activation and barriers counseling (n = 138) or CRC screening information (n = 132). Barriers counseling was attempted among activated patients if screening was not completed after one month. CRC screening test completion was determined by medical record review at two months after the medical visit. Logistic regression was used to determine whether activated patients were more likely to complete CRC screening, after adjustment for confounding factors (e.g., demographic characteristics and CRC knowledge).
  
  
  RESULTS
  Patients were African American (72.2%), female (63.7%), had annual household incomes less than $20,000 (60.7%), no health insurance (57.0%), and limited health literacy skills (53.7%). In adjusted analyses, more patients randomized to the activation group completed a screening test (19.6% vs. 9.9%; OR = 2.35, 95% CI: 1.14-5.56; P = 0.020). In addition, more activated patients reported discussing screening with their provider (54.4% vs. 27.5%, OR = 3.29, 95% CI: 1.95-5.56; P < 0.001) and had more screening tests ordered (39.1% vs. 17.6%; OR = 3.40, 95% CI: 1.88-6.15; P < 0.001) compared with those in the control group.
  
  
  CONCLUSIONS
  Patient activation increased CRC screening rates among low-income minority patients.
  
  
  CONCLUSIONS
  Innovative strategies are still needed to increase CRC screening discussions, motivate providers to recommend screening to patients, as well as assist patients to complete ordered screening tests.
authors: College of Public Health, The Ohio State University, Suite 525, 1590 North High Street, Columbus, Ohio 43201, USA. mira.katz@osumc.edu
authors: Mira L
authors: ML
authors: Katz
authors: James L
authors: JL
authors: Fisher
authors: Kelly
authors: K
authors: Fleming
authors: Electra D
authors: ED
authors: Paskett
mesh_terms: D001741:Black or African American; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000517:prevention & control; D003376:Counseling / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups; D010353:Patient Education as Topic / Q000379:methods*; D011203:Poverty / Q000208:ethnology / Q000523:psychology*