Abstract 1817: A computer-tailored intervention increases patient-provider discussion and appointment making for colorectal cancer screening
Authors: Krier Connie J. , Skinner Celette Sugg , Champion Victoria L. , Springston Jeffrey , Perkins Susan M. , Tong Yan , Gebregziabher Netsanet , Imperiale Thomas F. , Brady-Watts Tawana , Myers Laura J. , Rawl Susan M. 
Published: June 2012

BACKGROUND: Colorectal cancer (CRC) will affect more than 142,000 Americans and almost 52,000 will die from this disease this year. Approximately half of these deaths could be prevented if CRC screening were consistently implemented. Both CRC incidence and mortality rates are highest among African Americans compared to all other racial groups due, in part, to suboptimal screening rates. Interactive health communication, defined as “computer technology designed to access or transmit tailored health information or receive tailored guidance and support on a health-related issue”, can be efficacious in changing individual behavior.

PURPOSE: Our objective was to determine if a tailored, interactive computer-based intervention (ICI) on CRC would increase screening discussions between African American patients and their primary care providers. Applying Health Belief Model constructs, we developed an ICI which featured CRC-risk based screening recommendations as well as individually tailored and culturally appropriate messages. The program operated on a user-friendly tablet platform and required an average of 17 minutes to complete.

METHODS: We enrolled 556 African Americans who were due for CRC screening in a randomized clinical trial. The sample was predominantly low income (58% &lt; $15,000 annual income) and 50% male with a mean age of 58 years (sd = 6.3). Demographics did not vary significantly between the two treatment arms. Prior to meeting with primary care providers in the clinic, 273 (49%) patients used the ICI. The remaining 283 (51%) patients received a “usual care” intervention – a non-tailored, CRC screening informational brochure developed by the American Cancer Society. Follow-up telephone interviews were conducted within one week of the clinic visit.

RESULTS: Patients in the ICI group were significantly more likely to report talking with their doctor about having a colon screening test (ICI group = 63%, brochure group = 49%, p = 0.001). Colonoscopy was reported as the most frequently discussed test (ICI group = 54%, brochure group = 45%, p = 0.06). Importantly, 30% of the ICI group further reported having an appointment scheduled for a colonoscopy, compared to 21% of the brochure group (p = 0.02). Fecal occult blood test was reportedly discussed by less than one third of patients in both groups (ICI group = 32%, brochure group = 27%, p = 0.15). Few patients reported discussing sigmoidoscopy (ICI group = 9%, brochure group = 7%, p = 0.29).

CONCLUSION: Tailored interactive health communications can prompt patient-provider dialogue on CRC screening and colonoscopy appointment making. Future analyses will determine if discussions translate into completion of these preventive tests which, in turn, can decrease cancer incidence and mortality.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1817. doi:10.1158/1538-7445.AM2011-1817