Physician Intervention and Chinese Americans' Colorectal Cancer Screening

Am J Health Behav. 2018 Jan 1;42(1):13-26. doi: 10.5993/AJHB.42.1.2.

Abstract

Objective: We conducted a cluster-randomized trial evaluating an intervention that trained Chinese-American primary care physicians to increase their Chinese patients' colorectal cancer (CRC) screening.

Methods: Twenty-five physicians (13 randomized to the intervention arm and 12 to the control arm) and 479 of their patients (aged 50-75 and nonadherent to CRC screening guidelines) were enrolled. The intervention, guided by Social Cognitive Theory, included a communication guide and 2 in-office training sessions to enhance physicians' efficacy in com- municating CRC screening with patients. Patients' CRC screening rates (trial outcome) and rating of physician communication before intervention and at 12-month follow-up were assessed. Intention-to-treat analysis for outcome evaluation was conducted.

Results: Screening rates were slightly higher in the intervention vs. the control arm (24.4% vs. 17.7%, p = .24). In post hoc analyses, intervention arm patients who perceived better communication were more likely to be screened than those who did not (OR = 1.09, 95% CI: 1.03, 1.15). This relationship was not seen in the control arm.

Conclusions: This physician-focused intervention had small, non-significant effects in increasing Chinese patients' CRC screening rates. Physician communication appeared to explain intervention efficacy. More intensive interventions are needed to enhance Chinese patients' CRC screening.

Trial registration: ClinicalTrials.gov NCT01289288.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Asian
  • Colonoscopy
  • Colorectal Neoplasms / diagnosis*
  • Early Detection of Cancer*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Patient Compliance
  • Patient Participation*
  • Physician-Patient Relations*
  • Physicians, Primary Care*

Associated data

  • ClinicalTrials.gov/NCT01289288