Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups.

Patient Education and Counseling(2013)

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摘要
Tailoring to psychological constructs (e.g. self-efficacy, readiness) motivates behavior change, but whether knowledge tailoring alone changes healthcare preferences--a precursor of behavior change in some studies--is unknown. We examined this issue in secondary analyses from a randomized controlled trial of a tailored colorectal cancer (CRC) screening intervention, stratified by ethnicity/language subgroups (Hispanic/Spanish, Hispanic/English, non-Hispanic/English).Logistic regressions compared effects of a CRC screening knowledge-tailored intervention versus a non-tailored control on preferences for specific test options (fecal occult blood or colonoscopy), in the entire sample (N=1164) and the three ethnicity/language subgroups.Pre-intervention, preferences for specific tests did not differ significantly between study groups (experimental, 64.5%; control 62.6%). Post-intervention, more experimental participants (78.6%) than control participants (67.7%) preferred specific tests (P<0.001). Adjusting for pre-intervention preferences, more experimental group participants than control group participants preferred specific tests post-intervention [average marginal effect (AME)=9.5%, 95% CI 5.3-13.6; P<0.001]. AMEs were similar across ethnicity/language subgroups.Knowledge tailoring increased preferences for specific CRC screening tests across ethnic and language groups.If the observed preference changes are found to translate into behavior changes, then knowledge tailoring alone may enhance healthy behaviors.
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关键词
Colonoscopy,Colorectal neoplasms/diagnosis,Computer-assisted instruction/methods,Health behavior,Health knowledge,Attitudes, and practices,Healthcare disparities,Hispanic Americans,Language,Mass screening,Multicenter study,Multimedia,Occult blood,Patient acceptance of health care,Patient education as topic/methods,Patient preference
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