title: Promoting colorectal cancer screening discussion: a randomized controlled trial.
abstract: BACKGROUND
  Provider recommendation is a predictor of colorectal cancer (CRC) screening.
  
  
  OBJECTIVE
  To compare the effects of two clinic-based interventions on patient-provider discussions about CRC screening.
  
  
  METHODS
  Two-group RCT with data collected at baseline and 1 week post-intervention.
  
  
  METHODS
  African-American patients that were non-adherent to CRC screening recommendations (n=693) with a primary care visit between 2008 and 2010 in one of 11 urban primary care clinics.
  
  
  METHODS
  Participants received either a computer-delivered tailored CRC screening intervention or a nontailored informational brochure about CRC screening immediately prior to their primary care visit.
  
  
  METHODS
  Between-group differences in odds of having had a CRC screening discussion about a colon test, with and without adjusting for demographic, clinic, health literacy, health belief, and social support variables, were examined as predictors of a CRC screening discussion using logistic regression. Intervention effects on CRC screening test order by PCPs were examined using logistic regression. Analyses were conducted in 2011 and 2012.
  
  
  RESULTS
  Compared to the brochure group, greater proportions of those in the computer-delivered tailored intervention group reported having had a discussion with their provider about CRC screening (63% vs 48%, OR=1.81, p<0.001). Predictors of a discussion about CRC screening included computer group participation, younger age, reason for visit, being unmarried, colonoscopy self-efficacy, and family member/friend recommendation (all p-values <0.05).
  
  
  CONCLUSIONS
  The computer-delivered tailored intervention was more effective than a nontailored brochure at stimulating patient-provider discussions about CRC screening. Those who received the computer-delivered intervention also were more likely to have a CRC screening test (fecal occult blood test or colonoscopy) ordered by their PCP.
  
  
  BACKGROUND
  This study is registered at www.clinicaltrials.gov NCT00672828.
authors.affiliation: Department of Psychology, Purdue School of Science, Indiana University-Purdue University Indianapolis, Indiana.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Christy
authors.affiliation: School of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Perkins
authors.affiliation: School of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: Yan
authors.initials: Y
authors.lastname: Tong
authors.affiliation: School of Nursing, Indiana University, Indianapolis, Indiana.
authors.forename: Connie
authors.initials: C
authors.lastname: Krier
authors.affiliation: School of Nursing, Indiana University, Indianapolis, Indiana.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Champion
authors.affiliation: Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Celette Sugg
authors.initials: CS
authors.lastname: Skinner
authors.affiliation: College of Journalism and Mass Communication, University of Georgia, Athens, Georgia.
authors.forename: Jeffrey K
authors.initials: JK
authors.lastname: Springston
authors.affiliation: School of Medicine, Indiana University, Indianapolis, Indiana.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Imperiale
authors.affiliation: School of Nursing, Indiana University, Indianapolis, Indiana. Electronic address: srawl@iupui.edu.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Rawl
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D003113:Colonoscopy / Q000379:methods; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003201:Computers; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009780:Occult Blood; D010174:Pamphlets; D010349:Patient Compliance; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000458:organization & administration*; D020377:Self Efficacy; D012944:Social Support; D019037:Urban Health Services / Q000458:organization & administration