TSET Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 655 Research Parkway, Oklahoma City, OK 73104, USA.
Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, 900 N.E. 10th Street, Oklahoma City, OK 73104, USA.
Health Educ Res. 2022 Mar 24;37(2):79-93. doi: 10.1093/her/cyac002.
Colorectal cancer (CRC) screening rates are suboptimal, partly due to poor communication about CRC risk. More effective methods are needed to educate patients, but little research has examined best practices for communicating CRC risk. This multi-method study tests whether tailoring CRC risk information increases screening intentions. Participants (N = 738) were randomized with a 2:2:1 allocation to tailored, targeted, and control message conditions. The primary outcome was intention to screen for CRC (yes/no). Additional variables include perceived message relevance, perceived susceptibility to CRC, and free-text comments evaluating the intervention. A chi-square test determined differences in the proportion of participants who intended to complete CRC screening by condition. A logistic-based path analysis explored mediation. Free-text comments were analyzed using advanced topic modeling analysis. CRC screening intentions were highest in the tailored intervention and significantly greater than control (P = 0.006). The tailored message condition significantly increased message relevance compared with control (P = 0.027) and targeted conditions (P = 0.002). The tailored condition also increased susceptibility (P < 0.001) compared with control, which mediated the relationship between the tailored condition and intention to screen (b = 0.04, SE = 0.02, 95% confidence interval = 0.02, 0.09). The qualitative data reflect similar trends. The theoretical mechanisms and practical implications of tailoring health education materials about CRC risk are discussed.
结直肠癌（CRC）筛查率不理想，部分原因是对 CRC 风险的沟通不佳。需要更有效的方法来教育患者，但很少有研究探讨沟通 CRC 风险的最佳实践。这项多方法研究检验了针对 CRC 风险信息是否能增加筛查意向。参与者（N=738）随机分配到定制、靶向和对照信息条件，比例为 2:2:1。主要结果是筛查 CRC 的意向（是/否）。其他变量包括感知信息相关性、感知 CRC 易感性和评估干预措施的自由文本评论。卡方检验确定了按条件分组的参与者打算进行 CRC 筛查的比例差异。基于逻辑的路径分析探讨了中介作用。使用高级主题建模分析对自由文本评论进行了分析。在定制干预组中，CRC 筛查意向最高，明显高于对照组（P=0.006）。与对照组（P=0.027）和靶向条件（P=0.002）相比，定制消息条件显著提高了消息相关性。与对照组相比，定制条件还增加了易感性（P<0.001），这介导了定制条件与筛查意向之间的关系（b=0.04，SE=0.02，95%置信区间=0.02，0.09）。定性数据反映了类似的趋势。讨论了针对 CRC 风险健康教育材料进行定制的理论机制和实际意义。
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