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Impact of Tailored Interventions on Receipt of a Preference-Concordant Colorectal Cancer Screening Test.

Christy SM, Monahan PO, Stump TE, Rawl SM, Champion VL. Impact of Tailored Interventions on Receipt of a Preference-Concordant Colorectal Cancer Screening Test. Medical decision making : an international journal of the Society for Medical Decision Making. 2020 Jan 1; 40(1):29-41.

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Individuals at average risk for colorectal cancer (CRC) have multiple test options. Preference for a specific test modality may affect decision making about CRC screening. The current study examined 1) the sociodemographic and health belief characteristics of average-risk participants with a test preference for stool blood test (SBT) versus those with a preference of colonoscopy, and following receipt of a tailored CRC screening intervention, 2) the percentage of participants who completed a preference-concordant CRC screening test, and 3) the sociodemographic, health care experience, and health belief characteristics and intervention group(s) associated with completion of a preference-concordant screening test. Participants ( = 603) were female, aged 50 to 75 years, at average CRC risk, not currently up-to-date with CRC screening recommendations, had Internet access, and were randomized to receive 1 of 3 tailored CRC screening promotion interventions. Multivariable logistic regression analyses were conducted. Most women (64%) preferred SBT, whereas 36% preferred colonoscopy. There were significant differences in test preference by age, stage of change for the specific tests, perceived benefits of CRC screening, perceived barriers to both tests, and self-efficacy for colonoscopy. Two hundred thirty participants completed CRC screening at 6 months post-intervention. Of those, most (84%) completed a test concordant with their preference. Multivariable analyses revealed that compared with participants completing a preference-discordant test, those completing a preference-concordant test were older ( = 0.01), had health insurance ( < 0.05), and were in the phone counseling-only group ( < 0.01). High levels of completion of preference-concordant CRC screening can be achieved by educating average-risk patients about the multiple screening test options, soliciting their preferences, and offering testing that is concordant with their preference.

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