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Browsing by Subject "Computer-tailored intervention"
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Item 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 NursingIntroduction: 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.Item Development of a Computer-Tailored Intervention/Decision Aid To Increase Colorectal Cancer Screening in Health Systems(Cureus, 2022-03-21) Fatima, Hala; Wajid, Maryiam; Krier, Connie; Champion, Victoria; Carter-Harris, Lisa; Shedd-Steele, Rivienne; Imperiale, Thomas F.; Schwartz, Peter; Strom, Sylvia; Magnarella, Mark; Rawl, Susan M.; Medicine, School of MedicineBackground: Non-compliance with scheduled colonoscopy is common among patients, especially in underserved populations. High no-show and late cancelation rates result in wasted resources, increased costs, and missed opportunities for colorectal cancer (CRC) screening. Among the barriers to colonoscopy is a lack of knowledge about the benefits, fears, and limited time for patient counseling. Methodology: We produced a digital video disc and a website program to enhance awareness about CRC screening and address patient barriers in a population with low screening adherence. Results: Patients can be educated via an interactive computer-tailored intervention with both DVD and web versions. It details the benefits and need for CRC screening, different methods of screening, and addresses patient-related barriers. Conclusions: Patient education is crucial to increase CRC screening among eligible individuals. Because online engagement is affected by attention, interest, and affect, content should be concise but comprehensive.