title: Does patient time spent viewing computer-tailored colorectal cancer screening materials predict patient-reported discussion of screening with providers?
abstract: The main aim is to examine whether patients' viewing time on information about colorectal cancer (CRC) screening before a primary care physician (PCP) visit is associated with discussion of screening options during the visit. We analyzed data from a multi-center randomized controlled trial of a tailored interactive multimedia computer program (IMCP) to activate patients to undergo CRC screening, deployed in primary care offices immediately before a visit. We employed usage time information stored in the IMCP to examine the association of patient time spent using the program with patient-reported discussion of screening during the visit, adjusting for previous CRC screening recommendation and reading speed.On average, patients spent 33 minutes on the program. In adjusted analyses, 30 minutes spent using the program was associated with a 41% increase in the odds of the patient having a discussion with their PCP (1.04, 1.59, 95% CI). In a separate analysis of the tailoring modules; the modules encouraging adherence to the tailored screening recommendation and discussion with the patient's PCP yielded significant results. Other predictors of screening discussion included better self-reported physical health and increased patient activation. Time spent on the program predicted greater patient-physician discussion of screening during a linked visit.Usage time information gathered automatically by IMCPs offers promise for objectively assessing patient engagement around a topic and predicting likelihood of discussion between patients and their clinician.
authors.affiliation: Departments of Family Medicine and Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA mechelle_sanders@urmc.rochester.edu.
authors.forename: Mechelle
authors.initials: M
authors.lastname: Sanders
authors.affiliation: Departments of Family Medicine and Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.affiliation: Department of Public Health Science, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Veazie
authors.affiliation: Department of Public Health Science, University of Rochester Medical Center, Rochester, NY, USA.
authors.forename: James G
authors.initials: JG
authors.lastname: Dolan
authors.affiliation: Department of Family and Community Medicine, University of California Davis School of Medicine, Sacramento, CA, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Jerant
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000523:psychology; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D003194:Computer-Assisted Instruction; D055088:Early Detection of Cancer / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D013997:Time Factors