title: High self-efficacy predicts adherence to surveillance colonoscopy in inflammatory bowel disease.
abstract: BACKGROUND
  Patients with extensive ulcerative colitis or Crohn's disease of the colon have an increased risk of colon cancer and require colonoscopic surveillance. In this study, we assessed individual self-efficacy (SE) to estimate the probability of adherence to surveillance colonoscopies.
  
  
  METHODS
  Three hundred seventy-eight patients with ulcerative colitis or Crohn's disease of the colon for at least 7 years and with at least one third of the colon involved participated in this cross-sectional questionnaire study performed at 3 tertiary referral inflammatory bowel disease clinics. Medical charts were abstracted for demographic and clinical variables. The questionnaire contained a group of items assessing SE for undergoing colonoscopy.
  
  
  RESULTS
  We validated our 20-question SE scale and used 8 of the items that highlighted scheduling, preparation, and postprocedure recovery, to develop 2 shorter SE scales. All 3 scales were reliable with Cronbach's α ranging from 0.845 to 0.905 and correlated with chart-documented adherence to surveillance colonoscopy (P < 0.001). We then developed logistic regression models to predict adherence to surveillance colonoscopy using each scale separately along with other key variables (i.e., disease location, knowledge of correct adherence intervals, and information sources of patients consulted regarding Crohn's disease and ulcerative colitis) and demonstrated model accuracy up to 74%.
  
  
  CONCLUSIONS
  SE, as measured by our validated scales, correlates with chart-adherence to surveillance colonoscopy. Our adherence model, which includes SE, predicts adherence with 74% certainty. An 8-item validated clinical questionnaire can be administered to assess whether patients in this population may require further intervention for adherence.
authors.affiliation: *Department of Medicine, Division of Gastroenterology, Brigham and Women's Hospital; †Department of Medicine, Division of Gastroenterology, Beth Israel Deaconess Medical Center; ‡Department of Medicine, Section of Gastroenterology, Boston Medical Center, Boston, Massachusetts; and §Department of Analysis and Information Management, University of California, Los Angeles, California.
authors.forename: Sonia
authors.initials: S
authors.lastname: Friedman
authors.forename: Adam S
authors.initials: AS
authors.lastname: Cheifetz
authors.forename: Francis A
authors.initials: FA
authors.lastname: Farraye
authors.forename: Peter A
authors.initials: PA
authors.lastname: Banks
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Makrauer
authors.forename: Robert
authors.initials: R
authors.lastname: Burakoff
authors.forename: Barbara
authors.initials: B
authors.lastname: Farmer
authors.forename: Leanne N
authors.initials: LN
authors.lastname: Torgersen
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Wahl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003093:Colitis, Ulcerative / Q000503:physiopathology* / Q000523:psychology; D003110:Colonic Neoplasms / Q000517:prevention & control*; D003113:Colonoscopy; D003424:Crohn Disease / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D011159:Population Surveillance; D011379:Prognosis; D012307:Risk Factors; D020377:Self Efficacy; D057566:Self Report; D011795:Surveys and Questionnaires; D055815:Young Adult