This supplement seeks to fill a gap in the parent grant by exploring the more intermediate outcomes of participating in the currently funded intervention trial designed to increase colorectal cancer screening, as they specifically relate to doctor-patient communication. The supplemental study will be conducted in parallel to the parent study, with participants in the supplement being randomized to the same interactive intervention, generic information or standard care control conditions as those in the parent grant. Similar to participants in the parent grant, participants in the supplemental study will complete baseline and six month follow-up phone surveys and allow for their medical chart to be examined for verification of CRCS. The supplemental study will involve additional pre- and post-appointment quantitative assessments, an audio-recording of the doctor-patient interaction during a wellness visit, and a post-visit qualitative interview with patients. The supplement will capitalize on and augment the parent grant by using observational and qualitative research methods to provide detailed information about the content and process of patient-provider discussions of CRCS (or lack thereof). Better understanding of the more intermediate outcomes of interventions targeting cancer screening behaviors, such as patient-physician CRCS discussions and their effects on patients' CRCS decision making, will inform Specific Aim 3 from the parent grant concerning evaluation of intervention effects on CRCS, as well as direct future intervention design. Additionally, the application of existing innovations, such as audio-recorded doctor-patient interactions, to new areas of inquiry, such as cancer screening, will fill gaps in cancer prevention research. ? ? ?
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