A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening

Victoria Champion, Shannon M. Christy, William Rakowski, Wambui G. Gathirua-Mwangi, Will L. Tarver, Lisa Carter-Harris, Andrea Cohee, Andrew R. Marley, Nenette M. Jessup, Erika Biederman, Carla D. Kettler, Timothy E. Stump, Patrick Monahan, David R. Lairson, Susan Rawl

Research output: Contribution to journalArticle

Abstract

Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web þ phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web þ phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.

Original languageEnglish (US)
Pages (from-to)1433-1441
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume27
Issue number12
DOIs
StatePublished - Dec 1 2018

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Early Detection of Cancer
Colonoscopy
Counseling
Colorectal Neoplasms
Fear
Self Report
Medical Records
Primary Health Care
Guidelines
Mortality
Neoplasms

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening. / Champion, Victoria; Christy, Shannon M.; Rakowski, William; Gathirua-Mwangi, Wambui G.; Tarver, Will L.; Carter-Harris, Lisa; Cohee, Andrea; Marley, Andrew R.; Jessup, Nenette M.; Biederman, Erika; Kettler, Carla D.; Stump, Timothy E.; Monahan, Patrick; Lairson, David R.; Rawl, Susan.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 27, No. 12, 01.12.2018, p. 1433-1441.

Research output: Contribution to journalArticle

Champion, V, Christy, SM, Rakowski, W, Gathirua-Mwangi, WG, Tarver, WL, Carter-Harris, L, Cohee, A, Marley, AR, Jessup, NM, Biederman, E, Kettler, CD, Stump, TE, Monahan, P, Lairson, DR & Rawl, S 2018, 'A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening', Cancer Epidemiology Biomarkers and Prevention, vol. 27, no. 12, pp. 1433-1441. https://doi.org/10.1158/1055-9965.EPI-18-0180
Champion, Victoria ; Christy, Shannon M. ; Rakowski, William ; Gathirua-Mwangi, Wambui G. ; Tarver, Will L. ; Carter-Harris, Lisa ; Cohee, Andrea ; Marley, Andrew R. ; Jessup, Nenette M. ; Biederman, Erika ; Kettler, Carla D. ; Stump, Timothy E. ; Monahan, Patrick ; Lairson, David R. ; Rawl, Susan. / A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening. In: Cancer Epidemiology Biomarkers and Prevention. 2018 ; Vol. 27, No. 12. pp. 1433-1441.
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abstract = "Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web {\th} phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23{\%}). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7{\%}, P < 0.0001) and combined Web {\th} phone (35.8{\%}, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1{\%}), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.",
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T1 - A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening

AU - Champion, Victoria

AU - Christy, Shannon M.

AU - Rakowski, William

AU - Gathirua-Mwangi, Wambui G.

AU - Tarver, Will L.

AU - Carter-Harris, Lisa

AU - Cohee, Andrea

AU - Marley, Andrew R.

AU - Jessup, Nenette M.

AU - Biederman, Erika

AU - Kettler, Carla D.

AU - Stump, Timothy E.

AU - Monahan, Patrick

AU - Lairson, David R.

AU - Rawl, Susan

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web þ phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web þ phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.

AB - Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web þ phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web þ phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.

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