title: Assessing Colorectal Cancer Screening Barriers by Two Methods.
abstract: Colorectal cancer (CRC) is commonly diagnosed in the USA despite screening tests that have decreased CRC incidence and mortality. Finding the best method to identify patient-level screening barriers is important to improve CRC screening rates. A group-randomized trial was conducted among ten primary-care clinics. Clinics were randomized to a multi-level (clinic, provider, patient) CRC screening intervention or usual care (2007-2013). Subsequent to clinic- and provider-level interventions, a three-step, patient-level intervention was conducted. One step of the patient-level intervention was a CRC screening barriers counseling call conducted by a lay health advisor (LHA). During the call, two methods were used to identify CRC screening barriers. An open-ended question was used first to determine why participants had not completed screening (without probes). Subsequently, the LHA read a list of additional potential screening barriers and asked participants whether each barrier was applicable (with probes). A generalized estimating equation approach was used to compare the two methods. Participants (n = 109) were female (59%), had a mean age of 57.2 years, and were white (67%) or black (31%). Most participants had some college education or a college degree (79%), annual household income $30,000+ (60%), and health insurance (80%). The number of CRC screening barriers increased with probing compared to the open-ended question format (OR 2.10, 95% CI 1.92-2.31; p < 0.01). The ranking of reported CRC screening barriers did not vary by assessment method. However, the methodology used to document CRC screening barriers may influence the content of patient-directed interventions.
authors.affiliation: College of Public Health, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA. Mira.Katz@osumc.edu.|Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA. Mira.Katz@osumc.edu.|College of Medicine, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA. Mira.Katz@osumc.edu.
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Young
authors.affiliation: College of Public Health, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.|Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
authors.forename: Barret J
authors.initials: BJ
authors.lastname: Zimmermann
authors.affiliation: Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
authors.forename: Cathy M
authors.initials: CM
authors.lastname: Tatum
authors.affiliation: College of Public Health, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.|Comprehensive Cancer Center, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.|College of Medicine, The Ohio State University, Suite 525 1590 North High Street, Columbus, OH, 43201, USA.
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003376:Counseling; D055088:Early Detection of Cancer / Q000379:methods* / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: Colorectal neoplasms; Early detection of cancer; Screening