Abstract 770: Provider communication contributes to colorectal cancer screening intention through improving screening outcome expectancies and perceived behavioral control
Authors: Zhu Xuan , Limburg Paul , Squiers Linda , Helmueller Leah , Madson Gabriel , Southwell Brian , Gates Carlye , Alam Shama , Laffin Jennifer , Rutten Lila Finney 
Published: April 2023

Abstract
Background: Multiple guideline-recommended colorectal cancer (CRC) screening options have been shown to reduce CRC incidence and mortality among average-risk patients. Yet, CRC screening continues to be underutilized in the US. Provider recommendation has consistently shown to improve screening completion. Our study aimed to delineate the pathways through which provider communication influences CRC screening completion. We tested how provider communication about the "Why” and “How” of mt-sDNA screening contributes to mt-sDNA screening intention through influencing patients’ screening outcome expectancies and perceived behavioral control.
Methods: Data came from a behavioral theory-informed survey that we developed to identify psychosocial factors associated with mt-sDNA screening. The survey was administered between 3/22-6/22 by RTI International, with a sample of US adults ages 45-75 who received a valid order for mt-sDNA screening with a shipping date between 5/21-9/21. Participants completed an electronic or paper survey. We measured patients’ reports of providers’ “Why” communication with items on mt-sDNA screening performance, advantages/disadvantages, and cost. Providers’ “How” communication was measured with items on instructions and need for follow-up testing. We tested the proposed relationships using structural equation modeling and tested indirect effects using bootstrapping.
Results: A total of 2973 participants completed the survey (response rate: 21.7%). “Why” communication was positively associated with perceived effectiveness of mt-sDNA screening (b = 0.349, p &lt; .001) and negatively associated with CRC worry (b = -0.078, p = .002). “How” communication was positively associated with perceived ease of use (b = 0.392, p &lt; .001) and perceived comfort of mt-sDNA screening (b = 0.138, p &lt; .001). Perceived effectiveness and perceived ease of use were positively associated with intention to complete mt-sDNA screening (b = 0.404, p &lt; .001; b = 0.339, p &lt; .001). “Why” communication contributed to screening intention through influencing perceived effectiveness (b-indirect effect = 0.141, 95% CI: 0.115, 0.177). “How” communication contributed to screening intention through influencing perceived ease of use (b-indirect effect = 0.133, 95% CI: 0.104, 0.172).
Conclusions: Improving patients’ beliefs about the effectiveness and ease of use of screening may be one pathway through which provider communication contributes to CRC screening completion. Efforts are needed to develop and implement provider-patient communication strategies and toolkits that are efficacious at fostering patient understanding of the rationale for CRC screening and the effectiveness of available screening options as well as addressing barriers and enhancing patients’ self-efficacy in completing their preferred screening option.
Citation Format: Xuan Zhu, Paul Limburg, Linda Squiers, Leah Helmueller, Gabriel Madson, Brian Southwell, Carlye Gates, Shama Alam, Jennifer Laffin, Lila Finney Rutten. Provider communication contributes to colorectal cancer screening intention through improving screening outcome expectancies and perceived behavioral control [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 770.