A computerized intervention to promote colorectal cancer screening for underserved populations: theoretical background and algorithm development.
OBJECTIVE
The aim of this exploratory study was to assess factors deemed by patients as "important" as they planned and considered undergoing colorectal cancer (CRC) screening, and to use this data to design a computer-delivered intervention to promote screening.


METHODS
Fifty participants 50 years or older, not up-to-date with current recommended CRC screening guidelines, were recruited from a primary care clinic. A semi-structured interview focused on aspects of preparing for colorectal cancer screening was administered; after transcription, researchers used triangulation and consensus to identify relevant themes and concepts.


RESULTS
Four main themes were identified that dealt with issues important for both FOBT and colonoscopy planning: personal concerns, reminders, communication with healthcare providers and obtaining test results. FOBT specific themes included: sample collection and return. For colonoscopy screening, themes included: scheduling, intervention questions, colonoscopy preparation, and transportation. These can be classified as barrier, process and accessory themes. The developed computer-administered implementation intentions algorithm addressed all the identified concerns in a planned and sequential manner, in order to facilitate planning for CRC screening.


CONCLUSIONS
The results of this study suggest that appropriate reminders, explanations of procedures, and patient understanding of temporary life disruptions, help patients develop and accept a detailed screening plan.
Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
K Allen
KA
Greiner
Mugur V
MV
Geana
Aaron
A
Epp
Angela
A
Watson
Melissa
M
Filippi
Christine Makosky
CM
Daley
Kimberly K
KK
Engelman
Aimee S
AS
James
Marci
M
Campbell
D000554:Ambulatory Care Facilities; D003113:Colonoscopy / Q000379:methods / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility; D006801:Humans; D033182:Intention; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D015146:Midwestern United States; D009780:Occult Blood; D010353:Patient Education as Topic / Q000379:methods*; D011320:Primary Health Care; D012812:Sigmoidoscopy / Q000379:methods / Q000523:psychology