Risk and Reluctance: Understanding Impediments to Colorectal Cancer Screening

Weitzman, Elissa R.; Zapka, Jane G.; Estabrook, Barbara; Goins, Karin Valentine

doi:10.1006/pmed.2001.0838

Cited by 192 publications

(171 citation statements)

References 25 publications

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“…Compliance was also higher amongst those receiving an immunochemical kit (Hughes et al, unpublished results). Unlike other studies [32], however, there was little evidence amongst participants of an aversion to things 'rectal or faecal.' Participants appreciated the convenience and privacy of receiving the FOBT by mail.…”

Section: Discussioncontrasting

confidence: 93%

The view from two sides: a qualitative study of community and medical perspectives on screening for colorectal cancer using FOBT

Clavarino

Janda

Hughes

et al. 2004

Preventive Medicine

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Section: Discussioncontrasting

confidence: 93%

The view from two sides: a qualitative study of community and medical perspectives on screening for colorectal cancer using FOBT

Clavarino

Janda

Hughes

et al. 2004

Preventive Medicine

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“…Future programs need to account for racial/ethnic differences in beliefs, preferences and perceptions of CRC screening [18][19][20][21]. Research can address whether these targeted approaches are more successful for advancing screening than generic programs that are "one size fits all."…”

Section: Discussionmentioning

confidence: 99%

Racial/Ethnic Variations in Colorectal Cancer Screening Self-Efficacy,Fatalism and Risk Perception in a Safety-Net Clinic Population: Implications for Tailored Interventions

Cupertino²,

Young³

et al. 2013

J Community Med Health Educ

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Ethnic and racial minority groups in the U.S. receive fewer colorectal cancer (CRC) screening tests and are less likely to be up-to-date with CRC screening than the population as a whole. Access, limited awareness of CRC and barriers may, in part, be responsible for inhibiting widespread adoption of CRC screening among racial and ethnic minority groups. The purpose of this study was to examine the role of self-efficacy, fatalism and CRC risk perception across racial and ethnic groups in a diverse sample. This study was a cross-sectional analysis from baseline measures gathered on a group of patients recruited into a trial to track colorectal cancer screening in underserved adults over 50. Out of 470 Participants, 42% were non-Hispanic; 27% Hispanic and 28% non-Hispanic White. Hispanic and non-Hispanic Blacks were more likely to have fatalistic beliefs about CRC than non-Hispanic Whites. Non-Hispanic Blacks perceived higher risk of getting colon cancer. Self-efficacy for completing CRC screening was higher among NonHispanic Blacks than among Hispanics. Racial and ethnic differences in risk perceptions, fatalism and self-efficacy should be taken into consideration in future CRC interventions with marginalized and uninsured populations.

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“…8,9 At the same time, physicians report difficulty finding the time to educate their patients about preventive medicine interventions.…”

Section: Discussionmentioning

confidence: 99%

“…2,7 According to patients, 2 barriers to screening are lack of knowledge about CRC and confusion about the FOBT screening procedure. 8,9 At the same time, physicians report difficulty finding the time to educate their patients about preventive medicine interventions. [10][11][12] Computer-assisted instruction (CAI), the use of a computer program to deliver an educational message, offers the potential to overcome knowledge barriers and therefore improve screening rates.…”

mentioning

confidence: 99%

Using a computer to teach patients about fecal occult blood screening

et al. 2005

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OBJECTIVE:To determine whether a multimedia computer program could effectively teach patients about fecal occult blood testing (FOBT) and increase screening rates. DESIGN: Randomized trial.SETTING: University-affiliated, community-based Internal Medicine outpatient practice.PARTICIPANTS: All English-speaking patients aged 50 years and older who were offered FOBT screening by their providers were invited to participate. Two hundred and four patients enrolled in the study. Ten patients were later determined to be ineligible. INTERVENTIONS:Patients were randomized to either the educational multimedia computer program or usual nurse counseling about FOBT screening. Screening instructions were based on the material pre-printed on each test kit. Educational sessions were held in a private setting immediately after each patient's office visit. MEASUREMENTS AND MAIN RESULTS:A knowledge-assessment questionnaire was administered in a blinded fashion by telephone the following day. Successful screening was defined as return of the test kits within 30 d. Completion of the FOBT kits was similar in both groups: 62% (58/93) in the computer group and 63% (64/101) in the nurse group (P =.89). Mean knowledge scores were also similar, but there was a trend toward increased knowledge mastery in the computer group (56% vs 41%, P =.09). CONCLUSIONS:A multimedia educational computer program was as effective as usual nurse counseling in educating patients and achieving adherence to FOBT screening. Future studies are needed to determine whether computer-assisted instruction can improve health outcomes. Despite the proven ability of screening to reduce CRC mortality, fewer than 25% of Americans over age 50 have undergone FOBT screening within the past year, and half are not currently screened for CRC by any modality.2,7 According to patients, 2 barriers to screening are lack of knowledge about CRC and confusion about the FOBT screening procedure. 8,9 At the same time, physicians report difficulty finding the time to educate their patients about preventive medicine interventions. 10-12Computer-assisted instruction (CAI), the use of a computer program to deliver an educational message, offers the potential to overcome knowledge barriers and therefore improve screening rates. In contrast to usual office-based counseling or printed materials, CAI can combine graphics, video clips, and audio segments to reinforce the educational message. In addition, CAI standardizes the material being presented and allows patients to proceed at their own pace. Several randomized trials have demonstrated that CAI can increase patients' knowledge about health topics. [13][14][15][16][17][18] We are aware of no studies examining whether CAI can improve CRC screening rates. We hypothesized that CAI could educate patients about FOBT screening more effectively than individual counseling sessions and thereby increase the likelihood that patients will complete the screening procedure. To test this hypothesis, we conducted a randomized-controlled trial comparing a mu...

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Risk and Reluctance: Understanding Impediments to Colorectal Cancer Screening

Cited by 192 publications

References 25 publications

The view from two sides: a qualitative study of community and medical perspectives on screening for colorectal cancer using FOBT

The view from two sides: a qualitative study of community and medical perspectives on screening for colorectal cancer using FOBT

Racial/Ethnic Variations in Colorectal Cancer Screening Self-Efficacy,Fatalism and Risk Perception in a Safety-Net Clinic Population: Implications for Tailored Interventions

Using a computer to teach patients about fecal occult blood screening

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