A randomized trial of two print interventions to increase colon cancer screening among first-degree relatives

Susan Rawl, Victoria Champion, Linda L. Scott, Honghong Zhou, Patrick Monahan, Yan Ding, Patrick Loehrer, Celette Sugg Skinner

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Objective: First-degree relatives (FDRs) of people diagnosed with colorectal cancer (CRC) have a two- to threefold increased risk of developing the same disease. Tailored print interventions based on behavior change theories have demonstrated considerable promise in facilitating health-promoting behaviors. This study compared the impact of two mailed print interventions on CRC screening outcomes among FDRs. Methods: This randomized trial compared effects of two mailed print interventions - one tailored and one nontailored - on participation in CRC screening among FDRs of CRC survivors. Data collected via phone interviews from 140 FDRs at baseline, 1 week post-intervention, and 3 months post-intervention. Results: At 3 months, both the tailored and nontailored interventions yielded modest but statistically insignificant increases in adherence to any CRC screening test (14% vs. 21%, respectively; p = 0.30). While there were no main effects for tailored versus nontailored interventions, there were significant interactions that showed that the tailored print intervention had significantly greater effects on forward stage movement for CRC screening depending on stage of adoption at baseline, race, and objective CRC risk. Receipt of the tailored intervention was 2.5 times more likely to move baseline precontemplators and contemplators forward in stage of adoption for colonoscopy (95% CI: 1.10-5.68) and was three times more likely to move Caucasians forward in stage of adoption for FOBT (95% CI: 1.00-9.07). In addition, the tailored intervention was 7.7 times more likely to move people at average risk forward in stage of adoption for colonoscopy (95% CI: 1.25-47.75). Conclusion: The tailored print intervention was more effective at moving Caucasians, those in precontemplation and contemplation at baseline, and those at average risk forward in their stage of adoption for CRC screening. Practice implications: Both tailored and nontailored print interventions showed moderate effects for increasing CRC screening participation. Tailored print interventions may be more effective for certain subgroups.

Original languageEnglish
Pages (from-to)215-227
Number of pages13
JournalPatient Education and Counseling
Volume71
Issue number2
DOIs
StatePublished - May 2008

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Early Detection of Cancer
Colonic Neoplasms
Colorectal Neoplasms
Colonoscopy
Survivors
Interviews
Health

Keywords

  • Colon cancer
  • Randomized trial
  • Screening
  • Tailored intervention

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A randomized trial of two print interventions to increase colon cancer screening among first-degree relatives. / Rawl, Susan; Champion, Victoria; Scott, Linda L.; Zhou, Honghong; Monahan, Patrick; Ding, Yan; Loehrer, Patrick; Skinner, Celette Sugg.

In: Patient Education and Counseling, Vol. 71, No. 2, 05.2008, p. 215-227.

Research output: Contribution to journalArticle

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abstract = "Objective: First-degree relatives (FDRs) of people diagnosed with colorectal cancer (CRC) have a two- to threefold increased risk of developing the same disease. Tailored print interventions based on behavior change theories have demonstrated considerable promise in facilitating health-promoting behaviors. This study compared the impact of two mailed print interventions on CRC screening outcomes among FDRs. Methods: This randomized trial compared effects of two mailed print interventions - one tailored and one nontailored - on participation in CRC screening among FDRs of CRC survivors. Data collected via phone interviews from 140 FDRs at baseline, 1 week post-intervention, and 3 months post-intervention. Results: At 3 months, both the tailored and nontailored interventions yielded modest but statistically insignificant increases in adherence to any CRC screening test (14{\%} vs. 21{\%}, respectively; p = 0.30). While there were no main effects for tailored versus nontailored interventions, there were significant interactions that showed that the tailored print intervention had significantly greater effects on forward stage movement for CRC screening depending on stage of adoption at baseline, race, and objective CRC risk. Receipt of the tailored intervention was 2.5 times more likely to move baseline precontemplators and contemplators forward in stage of adoption for colonoscopy (95{\%} CI: 1.10-5.68) and was three times more likely to move Caucasians forward in stage of adoption for FOBT (95{\%} CI: 1.00-9.07). In addition, the tailored intervention was 7.7 times more likely to move people at average risk forward in stage of adoption for colonoscopy (95{\%} CI: 1.25-47.75). Conclusion: The tailored print intervention was more effective at moving Caucasians, those in precontemplation and contemplation at baseline, and those at average risk forward in their stage of adoption for CRC screening. Practice implications: Both tailored and nontailored print interventions showed moderate effects for increasing CRC screening participation. Tailored print interventions may be more effective for certain subgroups.",
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