Overall goal: to explore behavioral correlations between colorectal cancer (CRC) screening and screening mammography and develop an innovative approach for reducing barriers to CRC screening in women, using screening mammography, an existing non-colon cancer related screening test that has widespread public acceptance, as a """"""""teachable moment (TM)."""""""" This study will be the first prospective study to evaluate the effectiveness of an educational intervention designed to increase CRC screening administered at a cancer screening visit unrelated to CRC. Specific alms: 1) To evaluate screening mammography as a setting (or """"""""teachable moment"""""""") for administering CRC education; 2) To identify psychosocial barriers to colorectal cancer screening in women undergoing screening mammography;
Aim 1 includes two separate randomized clinical trials to evaluate the effect of a CRC educational video on CRC screening adherence in women (aims 1A/1B) and an observational study evaluating screening mammography as a TM.
Aim 1 A tests the efficacy of the CRC educational video intervention when administered during a screening mammography appointment.
Aim 1 B tests the efficacy of the CRC educational video intervention when administered during a general medicine clinic visit.
Aim 1 C tests the moderator effect of screening mammography on the effect of the educational intervention on CRC adherence using a quasi-experimental design by comparing the group receiving the CRC education intervention during screening mammography and the group who receive the same intervention during a noncancer screening-related clinic visit. The primary outcome for aim 1 is the proportion of women due for CRC screening who complete screening within 6 months of the intervention.
Aim 2 uses survey methods to identify psychosocial barriers to CRC screening, based on the integrated TM-preventive health model. A questionnaire will be prospectively administered to the participants prior to and immediately after the educational intervention. Baseline information elicited from the study questionnaire and demographic characteristics will be used as independent variables in a series of multivariable analyses to assess the impact of each predictor on the non-adherence to CRC screening. Predictor variables achieving statistical significance in the bivariate analyses (p<0.05) of non-adherence status and each of the potential predictor variables will be entered into a logistic model to determine independent variables associated with non-adherence to CRC screening. Forward stepwise logistic regression analysis will be used to determine factors predictive of non-adherence to any CRC screening strategy. The project culminates in development and submission of an R-01 grant for development and testing of tailored messages directed at barriers identified in aim 2 and the development, testing and evaluation of a tailored education intervention to be delivered in a """"""""teachable moment"""""""".
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