Cancer Control Research5R21CA093454-02
Rawl, Susan M.
INCREASING SCREENING IN FAMILIES WITH COLORECTAL CANCER
DESCRIPTION (provided by applicant): First-degree relatives of colorectal cancer (CRC) survivors have a two- to threefold increased risk of developing the same disease. Screening which leads to removal of precancerous polyps has been shown to decrease CRC incidence by 75-90%. Despite their increased risk, rates of participation in CRC screening among first-degree relatives are low. Tailored print interventions which are based on theories of behavior change have demonstrated considerable promise as interventions that motivate people to change health behaviors. The primary purpose of the proposed study is to develop and test the readership, relevance, and satisfaction of a theoretically-based tailored print intervention designed to increase participation in CRC screening among first-degree relatives of CRC survivors. A secondary purpose is to estimate the effect size of the tailored print intervention through comparison with a generic print intervention. The tailored print intervention will contain messages that are individually tailored for each participant based on baseline assessment of their individual demographics, CRC risk factors, health beliefs (perceived risk, benefits, barriers, self-efficacy), and stages of change for CRC screening. This preliminary efficacy study contrasts groups of first-degree relatives who will be randomly assigned to receive the tailored print intervention or the generic print intervention. Participants will be 220 first-degree relatives referred by CRC survivors. Data will be collected via structured telephone interviews at baseline, one week post-intervention, and three months post-baseline. Assessments of readership, relevance, and satisfaction with the print interventions will conducted one week post-intervention. Comparisons between tailored and generic interventions on readership relevance and satisfaction will be made using chi-square tests of independence. Preliminary effects of the interventions on knowledge, perceived risk, benefits, barriers, and self-efficacy at three months will be assessed using ANCOVA models. Screening participation will be assessed in two ways; coverage and compliance. Intervention effects on coverage and compliance will be estimated with logistics models adjusting for each demographic, family history, and index patient characteristics. Transition probabilities for stage of change will be calculated separately for the intervention groups for each screening test.