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Physician Intervention and Chinese Americans' Colorectal Cancer Screening

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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.
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Keywords: COLORECTAL CANCER SCREENING; PHYSICIAN-FOCUSED INTERVENTION

Document Type: Research Article

Affiliations: 1: Department of Oncology, and Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington DC, USA 2: Center for Asian Health, Lewis Katz School of Medicine, Philadelphia, PA, USA 3: Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA 4: Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington DC, USA 5: Center for Health Promotion and Prevention Research, University of Texas-Houston School of Public Health, Houston, TX, USA 6: Division of General Internal Medicine, Geriatrics and Bioethics, University of California Davis, Sacramento, CA, USA

Publication date: 01 January 2018

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

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