title: Comparing tailored and narrative worksite interventions at increasing colonoscopy adherence in adults 50-75: a randomized controlled trial.
abstract: Research has identified several communication strategies that could increase adherence to colorectal cancer screening recommendations. Two promising strategies are tailoring and narrative-based approaches. Tailoring is the personalization of information based on individual characteristics. Narrative-based approaches use stories about similar others to counter perceived barriers and cultivate self-efficacy. To compare these two approaches, a randomized controlled trial was carried out at 8 worksites in Indiana. Adults 50-75 (N = 209) received one of four messages about colorectal cancer screening: stock, narrative, tailored, tailored narrative. The primary outcome was whether participants filed a colonoscopy claim in the 18 months following the intervention. Individuals receiving narrative messages were 4 times more likely to screen than those not receiving narrative messages. Tailoring did not increase screening behavior overall. However, individuals with higher cancer information overload were 8 times more likely to screen if they received tailored messages. The results suggest that narrative-based approaches are more effective than tailoring at increasing colorectal cancer screening in worksite interventions. Tailoring may be valuable as a strategy for reaching individuals with high overload, perhaps as a follow-up effort to a larger communication campaign.
authors.affiliation: University of Utah, USA. Electronic address: jakob.jensen@utah.edu.
authors.forename: Jakob D
authors.initials: JD
authors.lastname: Jensen
authors.affiliation: Texas Tech University, USA.
authors.forename: Andy J
authors.initials: AJ
authors.lastname: King
authors.affiliation: University of Miami, USA.
authors.forename: Nick
authors.initials: N
authors.lastname: Carcioppolo
authors.affiliation: University of Utah, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Krakow
authors.affiliation: University of Utah, USA.
authors.forename: N Jewel
authors.initials: NJ
authors.lastname: Samadder
authors.affiliation: Purdue University, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Morgan
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000706:statistics & numerical data*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D033262:Narration; D016272:Occupational Health; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017132:Workplace
keywords: Cancer information overload; Colonoscopy; Narratives; Randomized controlled trial; Tailoring; United States; Worksite interventions