Randomized Controlled Trial of Tailored Interactive Multimedia to Reduce Colorectal Cancer Screening Disparities
Condition: Colorectal Neoplasms
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      The study investigators have developed an interactive multimedia computer program that
      provides personally tailored education about colorectal cancer screening in the user's
      preferred language (English or Spanish). In this study, the investigators will examine
      whether use of the computer program increases the number of Hispanic patients who receive
      colorectal cancer screening and lessens or eliminates the glaring disparity in screening
      between Hispanics and non-Hispanic whites.
    

Detailed description: 
      -  Background: Interactive multimedia computer programs (IMCPs) show promise as a way of
           delivering personally tailored (PT) information to enhance cognitive mediators of health
           behavior and improve patient outcomes. However, it is unclear whether PT IMCPs can be
           deployed in primary care offices to increase cancer screening uptake and eliminate
           ethnic disparities in uptake by providing PT information in each user's preferred
           language.

        -  Aims/Hypotheses: We will compare changes in colorectal cancer (CRC) screening cognitive
           mediators (self-efficacy, perceived barriers, and readiness) and uptake resulting from
           an IMCP - PT to enhance the key cognitive mediators and targeted to patients'
           self-identified ethnicity - with changes resulting from a non-tailored "electronic
           leaflet" control IMCP. The experimental and control IMCPs will each be offered in
           English and Spanish versions. We hypothesize that, compared with the appropriate control
           condition (English, Spanish, or both combined): (1) the English version of the PT IMCP
           will enhance the cognitive mediators of CRC screening behavior for English-speaking
           Hispanics and non-Hispanics; (2) there will be similarly favorable changes in these
           mediators for Hispanics using the Spanish version of the PT IMCP; (3) deployment of the
           PT IMCP will provide evidence of elimination of disparities in CRC screening between
           Hispanic and non-Hispanic subjects via its relative impact on the cognitive mediators in
           these groups; and (4) the PT IMCP (English and Spanish combined) will increase CRC
           screening uptake in Hispanics and non-Hispanics (considered separately) via changes in
           the cognitive mediators.

        -  Methods: Randomized controlled trial of 2 groups, comparing a PT (to the cognitive
           mediators) CRC screening IMCP offered in both English and Spanish versions and deployed
           before a primary care office visit with a non-tailored "electronic leaflet" CRC
           screening IMCP (control) also offered in both English and Spanish. Screening methods
           targeted will be fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy.
           Primary outcomes will be CRC screening uptake, self-efficacy, perceived barriers, and
           readiness.

        -  Implications: Our findings will determine whether an IMCP that is PT to cognitive
           mediators of screening behavior and deployed in primary care offices prior to previously
           scheduled visits can activate patients of various ethnicities to undergo CRC screening.
           They may also suggest a promising, portable method of reducing disparities in CRC (and
           other) screening uptake between Hispanic and non-Hispanic individuals.
    

Intervention name(s): Personally tailored computer program; Non-tailored control computer program
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The experimental computer program provides the user with information about colorectal cancer screening that is tailored to their self-efficacy, readiness, and perceived barriers to undergoing screening, in their preferred language (English or Spanish).; This program provides users with non-tailored information about colorectal cancer screening, in their preferred language (English or Spanish).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Screening
Keywords: Computer-assisted instruction; Health knowledge, attitudes, practice; Mass screening; Patient acceptance of health care; Patient education as topic; Primary health care; Self-efficacy