Communication preference moderates the effect of a tailored intervention to increase colorectal cancer screening among African Americans

Abstract

Objective: Test the impact of tailoring CRC screening messages for African Americans (AAs) using novel theoretical variables and to examine moderating effect of communication preferences.

Methods: Participants were randomized to receive two minimally tailored or two enhanced tailored print newsletters addressing CRC. The enhanced intervention was tailored on Self-Determination Theory and other novel psychological constructs. Minimal tailoring only used information available in the patient's EHR. The primary outcome was CRC screening based on EHR. Participants were AA members aged 50-74 of an integrated health care delivery system not up to date on CRC screening.

Results: We enrolled 881 participants. CRC screening participation rates at 1-year follow up were 20.5% and 21.5% in the minimally and enhanced tailored groups, respectively. Communication preferences moderated the impact of the intervention. Specifically, among those with an autonomous communication preference, screening rates in the minimally and enhanced tailored groups were 17.1% and 25.9%, respectively, while no intervention effect was evident among those with a directive preference.

Conclusion: Future research is needed to explore the impact of communication preference tailoring for other health behaviors and among other populations.

Practice implications: Tailored communications should consider communication style preference to help guide the content and tone of messages.

Keywords: African Americans; Colorectal cancer screening; Tailored intervention.

Conflict of interest statement

Conflict of interest statement: All authors received funding from National Cancer Institute grant P50-CA101451 but no other financial support for this work.

Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Figures

Figure 1. Screening Rates by Communication Preference and Intervention Group

* p = .04 EHR- Minimally tailored intervention based on Electronic Health Record information