TY - JOUR
T1 - Implementation intentions and colorectal screening
T2 - A randomized trial in safety-net clinics
AU - Greiner, K. Allen
AU - Daley, Christine M.
AU - Epp, Aaron
AU - James, Aimee
AU - Yeh, Hung Wen
AU - Geana, Mugur
AU - Born, Wendi
AU - Engelman, Kimberly K.
AU - Shellhorn, Jeremy
AU - Hester, Christina M.
AU - Lemaster, Joseph
AU - Buckles, Daniel C.
AU - Ellerbeck, Edward F.
N1 - Funding Information:
The study was supported by grant no. CA123245 from the National Cancer Institute . All opinions expressed herein are the sole responsibility of the authors and do not reflect the views of the National Institutes of Health. Fecal immunochemical tests were provided for the study by Enterix Inc., 236 Fernwood Avenue, Edison NJ 08337. Laboratory analysis of InSure© test specimens was provided by Quest Diagnostics, Inc., Lenexa KS 66219. Trial Registry Name: ClinicalTrials.gov: ClinicalTrials.gov identifier: NCT00594113; registered January 3, 2008. University of Kansas Medical Center IRB approval August 24, 2007.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Context Low-income and racial/ethnic minority populations experience disproportionate colorectal cancer (CRC) burden and poorer survival. Novel behavioral strategies are needed to improve screening rates in these groups. Background The study aimed to test a theoretically based "implementation intentions" intervention for improving CRC screening among unscreened adults in urban safety-net clinics. Design Randomized controlled trial. Setting/participants Adults (N=470) aged ≥50 years, due for CRC screening, from urban safety-net clinics were recruited. Intervention The intervention (conducted in 2009-2011) was delivered via touchscreen computers that tailored informational messages to decisional stage and screening barriers. The computer then randomized participants to generic health information on diet and exercise (Comparison group) or "implementation intentions" questions and planning (Experimental group) specific to the CRC screening test chosen (fecal immunochemical test or colonoscopy). Main outcome measures The primary study outcome was completion of CRC screening at 26 weeks based on test reports (analysis conducted in 2012-2013).Results The study population had a mean age of 57 years and was 42% non-Hispanic African American, 28% non-Hispanic white, and 27% Hispanic. Those receiving the implementation intentions-based intervention had higher odds (AOR=1.83, 95% CI=1.23, 2.73) of completing CRC screening than the Comparison group. Those with higher self-efficacy for screening (AOR=1.57, 95% CI=1.03, 2.39), history of asthma (AOR=2.20, 95% CI=1.26, 3.84), no history of diabetes (AOR=1.86, 95% CI=1.21, 2.86), and reporting they had never heard that "cutting on cancer" makes it spread (AOR=1.78, 95% CI=1.16, 2.72) were more likely to complete CRC screening.Conclusions The results of this study suggest that programs incorporating an implementation intentions approach can contribute to successful completion of CRC screening even among very low-income and diverse primary care populations. Future initiatives to reduce CRC incidence and mortality disparities may be able to employ implementation intentions in large-scale efforts to encourage screening and prevention behaviors.
AB - Context Low-income and racial/ethnic minority populations experience disproportionate colorectal cancer (CRC) burden and poorer survival. Novel behavioral strategies are needed to improve screening rates in these groups. Background The study aimed to test a theoretically based "implementation intentions" intervention for improving CRC screening among unscreened adults in urban safety-net clinics. Design Randomized controlled trial. Setting/participants Adults (N=470) aged ≥50 years, due for CRC screening, from urban safety-net clinics were recruited. Intervention The intervention (conducted in 2009-2011) was delivered via touchscreen computers that tailored informational messages to decisional stage and screening barriers. The computer then randomized participants to generic health information on diet and exercise (Comparison group) or "implementation intentions" questions and planning (Experimental group) specific to the CRC screening test chosen (fecal immunochemical test or colonoscopy). Main outcome measures The primary study outcome was completion of CRC screening at 26 weeks based on test reports (analysis conducted in 2012-2013).Results The study population had a mean age of 57 years and was 42% non-Hispanic African American, 28% non-Hispanic white, and 27% Hispanic. Those receiving the implementation intentions-based intervention had higher odds (AOR=1.83, 95% CI=1.23, 2.73) of completing CRC screening than the Comparison group. Those with higher self-efficacy for screening (AOR=1.57, 95% CI=1.03, 2.39), history of asthma (AOR=2.20, 95% CI=1.26, 3.84), no history of diabetes (AOR=1.86, 95% CI=1.21, 2.86), and reporting they had never heard that "cutting on cancer" makes it spread (AOR=1.78, 95% CI=1.16, 2.72) were more likely to complete CRC screening.Conclusions The results of this study suggest that programs incorporating an implementation intentions approach can contribute to successful completion of CRC screening even among very low-income and diverse primary care populations. Future initiatives to reduce CRC incidence and mortality disparities may be able to employ implementation intentions in large-scale efforts to encourage screening and prevention behaviors.
UR - http://www.scopus.com/inward/record.url?scp=84911994473&partnerID=8YFLogxK
U2 - 10.1016/j.amepre.2014.08.005
DO - 10.1016/j.amepre.2014.08.005
M3 - Article
C2 - 25455115
AN - SCOPUS:84911994473
SN - 0749-3797
VL - 47
SP - 703
EP - 714
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 6
ER -