Browsing by Author "Springston, Jeffrey"

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    Computer-tailored intervention increases colorectal cancer screening among low-income African Americans in primary care: Results of a randomized trial
    (Elsevier, 2021) Rawl, Susan M.; Christy, Shannon M.; Perkins, Susan M.; Tong, Yan; Krier, Connie; Wang, Hsiao-Lan; Huang, Amelia M.; Laury, Esther; Rhyant, Broderick; Lloyd, Frank; Willis, Deanna R.; Imperiale, Thomas F.; Myers, Laura J.; Springston, Jeffrey; Sugg Skinner, Celette; Champion, Victoria L.; School of Nursing
    Introduction: Although African Americans have the highest colorectal cancer (CRC) incidence and mortality rates of any racial group, their screening rates remain low. Study design/purpose: This randomized controlled trial compared efficacy of two clinic-based interventions for increasing CRC screening among African American primary care patients. Methods: African American patients from 11 clinics who were not current with CRC screening were randomized to receive a computer-tailored intervention (n = 335) or a non-tailored brochure (n = 358) designed to promote adherence to CRC screening. Interventions were delivered in clinic immediately prior to a provider visit. Univariate and multivariable logistic regression models analyzed predictors of screening test completion. Moderators and mediators were determined using multivariable linear and logistic regression analyses. Results: Significant effects of the computer-tailored intervention were observed for completion of a stool blood test (SBT) and completion of any CRC screening test (SBT or colonoscopy). The colonoscopy screening rate was higher among those receiving the computer-tailored intervention group compared to the nontailored brochure but the difference was not significant. Predictors of SBT completion were: receipt of the computer-tailored intervention; being seen at a Veterans Affairs Medical Center clinic; baseline stage of adoption; and reason for visit. Mediators of intervention effects were changes in perceived SBT barriers, changes in perceived colonoscopy benefits, changes in CRC knowledge, and patient-provider discussion. Moderators of intervention effects were age, employment, and family/friend recommendation of screening. Conclusion: This one-time computer-tailored intervention significantly improved CRC screening rates among low-income African American patients. This finding was largely driven by increasing SBT but the impact of the intervention on colonoscopy screening was strong. Implementation of a CRC screening quality improvement program in the VA site that included provision of stool blood test kits and follow-up likely contributed to the strong intervention effect observed at that site.
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    Interventions to Promote Colorectal Cancer Screening in Primary Care: Results of a Randomized Trial
    (Office of the Vice Chancellor for Research, 2013-04-05) Rawl, Susan M.; Christy, Shannon M.; Perkins, Susan; Tong, Yan; Krier, Connie; Wang, Hsiao-Lan; Champion, Victoria L.; Myers, Laura Jones; Imperiale, Thomas; Willis, Deanna; Rhyant, Broderick; Springston, Jeffrey; Skinner, Celette Sugg
    Aims: The purpose of this randomized trial was to compare rates of self-reported colorectal cancer (CRC) screening and forward movement in stage of adoption at 6 months post-intervention. African American primary care patients (n=595) who were eligible for CRC screening were randomly assigned to receive a computer-delivered tailored CRC screening intervention (n=286) or a non-tailored screening brochure (n=309) prior to their scheduled visit with their primary care provider. Hypotheses were that differences between groups would be observed in proportions of patients who: 1) completed fecal occult blood tests (FOBT) or colonoscopy; and 2) had moved forward in stages of adoption for these tests. Methods: Participants completed baseline and 6-month telephone interviews; interventions were delivered prior to primary care provider visits. Differences between groups were examined using chi-square tests, predictors of screening were determined using logistic regression models. Results: In the computer-tailored group, the FOBT completion rate was 12.6% compared to 7.8% in the brochure group (p=0.05). The colonoscopy completion rate was 17.5% in the computer group vs. 15.2% in the brochure group (p=0.45). Forward stage movement for FOBT was observed in 28.4% of the computer groups vs. 20.8% in the brochure group (p=0.03). Forward stage movement for colonoscopy was 38.5% in the computer group and 36.8% (p=0.68) in each group, respectively. Conclusions: The computer-tailored intervention was more effective than the brochure at increasing FOBT completion and movement toward action. More research is needed to explain why the tailored intervention was not more effective at increasing colonoscopy completion and to identify moderators of intervention efficacy.
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    Process outcomes from a randomized controlled trial comparing tailored mammography interventions delivered via telephone versus DVD
    (2011-11) Skinner, Celette Sugg; Buchanan, Adam; Champion, Victoria; Monahan, Patrick; Rawl, Susan M.; Springston, Jeffrey; Qianqian, Zhao; Bourff, Sara
    Objective Tailored, interactive mammography-promotion interventions can increase adherence if women are exposed to and find them usable. We compare exposure to and usability of interventions delivered via telephone vs. DVD. Methods Process evaluation measures from 926 women randomly assigned to telephone or DVD intervention and completing post-intervention surveys. Results ∼83% of each group reported exposure to all content. Partial exposure was higher for DVD (9% vs. 0.4%; p < .01); no exposure was higher for phone (15% vs. 8%; p < .01). There were no differences in exposure by age or race. Full phone exposure was less likely for women who already made mammography appointments. Usability rating was higher for DVD (p < .05), driven by ratings of understandability and length. Usability of both interventions was correlated with lower baseline barriers, and higher fear, benefits, and self efficacy. Higher ratings for phone were associated with lower knowledge and contemplating mammography. Non-whites rated DVD better than whites. Conclusion Both tailored interactive interventions had wide reach and favorable ratings, but DVD recipients had greatest exposure to at least partial content and more favorable ratings, especially among non-white women. Practice implications This first evaluation of a tailored, interactive DVD provides promise for its use in mammography promotion.