Correlates of Patient Intent and Preference on Colorectal Cancer Screening

Masahito Jimbo, Ananda Sen, Melissa A. Plegue, Sarah T. Hawley, Karen Kelly-Blake, Mary Rapai, Minling Zhang, Yuhong Zhang, Mack T. Ruffin

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction Information is limited on patient characteristics that influence their preference among screening options and intent to be screened for colorectal cancer (CRC). A mechanistic pathway to intent and preference was examined through a formal mediation analysis. Methods From 2012 to 2014, a total of 570 adults aged 50–75 years were recruited from 15 primary care practices in Metro Detroit for a trial on decision aids for CRC screening. Confirmatory factor, regression, and mediation analyses were performed in 2015–2016 on baseline cross-sectional data. Main outcomes were patient intent and preference. Perceived risk and self-efficacy were secondary outcomes. Covariates included demographic information, health status, previous CRC screening experience, patient attitudes, and knowledge. Results Mean age was 57.7 years, 56.1% were women, and 55.1% white and 36.6% black. Women had 32% and 41% lower odds than men of perceiving CRC to be high/moderate risk (OR=0.68, 95% CI=0.47, 0.97, p=0.03) and having high self-efficacy (OR=0.59, 95% CI=0.42, 0.85, p=0.006), respectively. Whites had 63% and 47% lower odds than blacks of having high self-efficacy (OR=0.37, 95% CI=0.25, 0.57, p<0.001) and intent to undergo CRC screening (OR=0.53, 95% CI=0.34, 0.84, p=0.007), respectively. Younger age, higher knowledge, lower level of test worries, and medium/high versus low self-efficacy increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent. Conclusions Self-efficacy mediated the association between race, attitude, and test worries and patient intent.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalAmerican Journal of Preventive Medicine
Volume52
Issue number4
DOIs
StatePublished - Apr 1 2017

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Patient Preference
Self Efficacy
Early Detection of Cancer
Colorectal Neoplasms
Decision Support Techniques
Health Status
Primary Health Care
Regression Analysis
Demography

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

Jimbo, Masahito ; Sen, Ananda ; Plegue, Melissa A. ; Hawley, Sarah T. ; Kelly-Blake, Karen ; Rapai, Mary ; Zhang, Minling ; Zhang, Yuhong ; Ruffin, Mack T. / Correlates of Patient Intent and Preference on Colorectal Cancer Screening. In: American Journal of Preventive Medicine. 2017 ; Vol. 52, No. 4. pp. 443-450.
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title = "Correlates of Patient Intent and Preference on Colorectal Cancer Screening",
abstract = "Introduction Information is limited on patient characteristics that influence their preference among screening options and intent to be screened for colorectal cancer (CRC). A mechanistic pathway to intent and preference was examined through a formal mediation analysis. Methods From 2012 to 2014, a total of 570 adults aged 50–75 years were recruited from 15 primary care practices in Metro Detroit for a trial on decision aids for CRC screening. Confirmatory factor, regression, and mediation analyses were performed in 2015–2016 on baseline cross-sectional data. Main outcomes were patient intent and preference. Perceived risk and self-efficacy were secondary outcomes. Covariates included demographic information, health status, previous CRC screening experience, patient attitudes, and knowledge. Results Mean age was 57.7 years, 56.1{\%} were women, and 55.1{\%} white and 36.6{\%} black. Women had 32{\%} and 41{\%} lower odds than men of perceiving CRC to be high/moderate risk (OR=0.68, 95{\%} CI=0.47, 0.97, p=0.03) and having high self-efficacy (OR=0.59, 95{\%} CI=0.42, 0.85, p=0.006), respectively. Whites had 63{\%} and 47{\%} lower odds than blacks of having high self-efficacy (OR=0.37, 95{\%} CI=0.25, 0.57, p<0.001) and intent to undergo CRC screening (OR=0.53, 95{\%} CI=0.34, 0.84, p=0.007), respectively. Younger age, higher knowledge, lower level of test worries, and medium/high versus low self-efficacy increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent. Conclusions Self-efficacy mediated the association between race, attitude, and test worries and patient intent.",
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Jimbo, M, Sen, A, Plegue, MA, Hawley, ST, Kelly-Blake, K, Rapai, M, Zhang, M, Zhang, Y & Ruffin, MT 2017, 'Correlates of Patient Intent and Preference on Colorectal Cancer Screening', American Journal of Preventive Medicine, vol. 52, no. 4, pp. 443-450. https://doi.org/10.1016/j.amepre.2016.11.026

Correlates of Patient Intent and Preference on Colorectal Cancer Screening. / Jimbo, Masahito; Sen, Ananda; Plegue, Melissa A.; Hawley, Sarah T.; Kelly-Blake, Karen; Rapai, Mary; Zhang, Minling; Zhang, Yuhong; Ruffin, Mack T.

In: American Journal of Preventive Medicine, Vol. 52, No. 4, 01.04.2017, p. 443-450.

Research output: Contribution to journalArticle

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AU - Jimbo, Masahito

AU - Sen, Ananda

AU - Plegue, Melissa A.

AU - Hawley, Sarah T.

AU - Kelly-Blake, Karen

AU - Rapai, Mary

AU - Zhang, Minling

AU - Zhang, Yuhong

AU - Ruffin, Mack T.

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N2 - Introduction Information is limited on patient characteristics that influence their preference among screening options and intent to be screened for colorectal cancer (CRC). A mechanistic pathway to intent and preference was examined through a formal mediation analysis. Methods From 2012 to 2014, a total of 570 adults aged 50–75 years were recruited from 15 primary care practices in Metro Detroit for a trial on decision aids for CRC screening. Confirmatory factor, regression, and mediation analyses were performed in 2015–2016 on baseline cross-sectional data. Main outcomes were patient intent and preference. Perceived risk and self-efficacy were secondary outcomes. Covariates included demographic information, health status, previous CRC screening experience, patient attitudes, and knowledge. Results Mean age was 57.7 years, 56.1% were women, and 55.1% white and 36.6% black. Women had 32% and 41% lower odds than men of perceiving CRC to be high/moderate risk (OR=0.68, 95% CI=0.47, 0.97, p=0.03) and having high self-efficacy (OR=0.59, 95% CI=0.42, 0.85, p=0.006), respectively. Whites had 63% and 47% lower odds than blacks of having high self-efficacy (OR=0.37, 95% CI=0.25, 0.57, p<0.001) and intent to undergo CRC screening (OR=0.53, 95% CI=0.34, 0.84, p=0.007), respectively. Younger age, higher knowledge, lower level of test worries, and medium/high versus low self-efficacy increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent. Conclusions Self-efficacy mediated the association between race, attitude, and test worries and patient intent.

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