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Correlates of Patient Intent and Preference on Colorectal Cancer Screening.
Jimbo M, Sen A, Plegue MA, Hawley ST, Kelly-Blake K, Rapai M, Zhang M, Zhang Y, Ruffin MT. Correlates of Patient Intent and Preference on Colorectal Cancer Screening. American journal of preventive medicine. 2017 Apr 1; 52(4):443-450.
Information is limited on patient characteristics that influence their preference among screening options and intent to be screened for colorectal cancer (CRC). A mechanistic pathway to intent and preference was examined through a formal mediation analysis.
From 2012 to 2014, a total of 570 adults aged 50-75 years were recruited from 15 primary care practices in Metro Detroit for a trial on decision aids for CRC screening. Confirmatory factor, regression, and mediation analyses were performed in 2015-2016 on baseline cross-sectional data. Main outcomes were patient intent and preference. Perceived risk and self-efficacy were secondary outcomes. Covariates included demographic information, health status, previous CRC screening experience, patient attitudes, and knowledge.
Mean age was 57.7 years, 56.1% were women, and 55.1% white and 36.6% black. Women had 32% and 41% lower odds than men of perceiving CRC to be high/moderate risk (OR = 0.68, 95% CI = 0.47, 0.97, p = 0.03) and having high self-efficacy (OR = 0.59, 95% CI = 0.42, 0.85, p = 0.006), respectively. Whites had 63% and 47% lower odds than blacks of having high self-efficacy (OR = 0.37, 95% CI = 0.25, 0.57, p < 0.001) and intent to undergo CRC screening (OR = 0.53, 95% CI = 0.34, 0.84, p = 0.007), respectively. Younger age, higher knowledge, lower level of test worries, and medium/high versus low self-efficacy increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent.
Self-efficacy mediated the association between race, attitude, and test worries and patient intent.