A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening

TY - JOUR

T1 - A randomized trial to compare a tailored web-based intervention and tailored phone counseling to usual care for increasing colorectal cancer screening

AU - Champion, Victoria L.

AU - Christy, Shannon M.

AU - Rakowski, William

AU - Gathirua-Mwangi, Wambui G.

AU - Tarver, Will L.

AU - Carter-Harris, Lisa

AU - Cohee, Andrea A.

AU - Marley, Andrew R.

AU - Jessup, Nenette M.

AU - Biederman, Erika

AU - Kettler, Carla D.

AU - Stump, Timothy E.

AU - Monahan, Patrick

AU - Lairson, David R.

AU - Rawl, Susan M.

N1 - Publisher Copyright: © 2018 American Association for Cancer Research.

PY - 2018/12

Y1 - 2018/12

N2 - Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web þ phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web þ phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.

AB - Background: Colorectal cancer mortality could be decreased with risk-appropriate cancer screening. We examined the efficacy of three tailored interventions compared with usual care for increasing screening adherence. Methods: Women (n = 1,196) ages 51 to 74, from primary care networks and nonadherent to colorectal cancer guidelines, were randomized to (1) usual care, (2) tailored Web intervention, (3) tailored phone intervention, or (4) tailored Web þ phone intervention. Average-risk women could select either stool test or colonoscopy, whereas women considered at higher than average risk received an intervention that supported colonoscopy. Outcome data were collected at 6 months by self-report, followed by medical record confirmation (attrition of 23%). Stage of change for colorectal cancer screening (precontemplation or contemplation) was assessed at baseline and 6 months. Results: The phone (41.7%, P < 0.0001) and combined Web þ phone (35.8%, P < 0.001) interventions significantly increased colorectal cancer screening by stool test compared with usual care (11.1%), with ORs ranging from 5.4 to 6.8 in models adjusted for covariates. Colonoscopy completion did not differ between groups except that phone significantly increased colonoscopy completion compared with usual care for participants in the highest tertile of self-reported fear of cancer. Conclusions: A tailored phone with or without a Web component significantly increased colorectal cancer screening compared with usual care, primarily through stool testing, and phone significantly increased colonoscopy compared with usual care but only among those with the highest levels of baseline fear. Impact: This study supports tailored phone counseling with or without a Web program for increasing colorectal cancer screening in average-risk women.

UR - http://www.scopus.com/inward/record.url?scp=85057718237&partnerID=8YFLogxK

U2 - 10.1158/1055-9965.EPI-18-0180

DO - 10.1158/1055-9965.EPI-18-0180

M3 - Article

C2 - 30181203

SN - 1055-9965

VL - 27

SP - 1433

EP - 1441

JO - Cancer Epidemiology Biomarkers and Prevention

JF - Cancer Epidemiology Biomarkers and Prevention

IS - 12

ER -