title: Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups.
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.
  
  
  CONCLUSIONS
  Knowledge tailoring increased preferences for specific CRC screening tests across ethnic and language groups.
  
  
  CONCLUSIONS
  If the observed preference changes are found to translate into behavior changes, then knowledge tailoring alone may enhance healthy behaviors.
authors.affiliation: Department of Family and Community Medicine, Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, CA 95817, USA. afjerant@ucdavis.edu
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
authors.forename: Richard L
authors.initials: RL
authors.lastname: Kravitz
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Nancy
authors.initials: N
authors.lastname: Sohler
authors.forename: Raquel Lozano
authors.initials: RL
authors.lastname: Romero
authors.forename: Bennett
authors.initials: B
authors.lastname: Parnes
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.forename: Charles
authors.initials: C
authors.lastname: Turner
authors.forename: Simon
authors.initials: S
authors.lastname: Dvorak
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D005006:Ethnicity / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D007802:Language; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D009780:Occult Blood; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D057240:Patient Preference / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011320:Primary Health Care; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data