title: Increasing colon cancer screening in primary care among African Americans.
abstract: BACKGROUND
  The study aimed to determine the effect of preference-based tailored navigation on colorectal cancer (CRC) screening adherence and related outcomes among African Americans (AAs).
  
  
  METHODS
  We conducted a randomized controlled trial that included 764 AA patients who were age 50 to 75 years, were eligible for CRC screening, and had received care through primary care practices in Philadelphia. Consented patients completed a baseline telephone survey and were randomized to either a Standard Intervention (SI) group (n = 380) or a Tailored Navigation Intervention (TNI) group (n = 384). The SI group received a mailed stool blood test kit plus colonoscopy instructions, and a reminder. The TNI group received tailored navigation (a mailed stool blood test kit or colonoscopy instructions based on preference, plus telephone navigation) and a reminder. A six-month survey and a 12-month medical records review were completed to assess screening adherence, change in overall screening preference, and perceptions about screening. Multivariable analyses were performed to assess intervention impact on outcomes.
  
  
  RESULTS
  At six months, adherence in the TNI group was statistically significantly higher than in the SI group (OR = 2.1, 95% CI = 1.5 to 2.9). Positive change in overall screening preference was also statistically significantly greater in the TNI group compared with the SI group (OR = 1.5, 95% CI = 1.0 to 2.3). There were no statistically significant differences in perceptions about screening between the study groups.
  
  
  CONCLUSIONS
  Tailored navigation in primary care is a promising approach for increasing CRC screening among AAs. Research is needed to determine how to maximize intervention effects and to test intervention impact on race-related disparities in mortality and survival.
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV). ronald.myers@jefferson.edu.
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Myers
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Randa
authors.initials: R
authors.lastname: Sifri
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Constantine
authors.initials: C
authors.lastname: Daskalakis
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Melissa
authors.initials: M
authors.lastname: DiCarlo
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Praveen Ramakrishnan
authors.initials: PR
authors.lastname: Geethakumari
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: James
authors.initials: J
authors.lastname: Cocroft
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Christopher
authors.initials: C
authors.lastname: Minnick
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Nancy
authors.initials: N
authors.lastname: Brisbon
authors.affiliation: : Division of Population Science, Medical Oncology (REM, MD, JC), Department of Family and Community Medicine (RS, NB), and Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics (CD), Thomas Jefferson University, Philadelphia, PA; Department of Internal Medicine, Albert Einstein Healthcare Network (PRG); Cancer Center, Albert Einstein Healthcare Network, Philadelphia, PA (CM); Division of Health Promotion and Behavioral Sciences, Center for Health Promotion and Prevention Research, University of Texas School of Public Health, Houston, TX (SWV).
authors.forename: Sally W
authors.initials: SW
authors.lastname: Vernon
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000517:prevention & control*; D003113:Colonoscopy; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D009780:Occult Blood; D010349:Patient Compliance / Q000706:statistics & numerical data; D062526:Patient Navigation / Q000379:methods; D015143:Philadelphia / Q000453:epidemiology; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011322:Primary Prevention / Q000379:methods; D017010:Reminder Systems; D013689:Telephone