More comprehensive discussion of CRC screening associated with higher screening

David M. Mosen, Adrianne C. Feldstein, Nancy A Perrin, A. Gabriela Rosales, David H. Smith, Elizabeth G. Liles, Jennifer L. Schneider, Ronald E. Myers, Jennifer Elston-Lafata

Research output: Contribution to journalArticle

Abstract

Objectives: Examine association of comprehensiveness of colorectal cancer (CRC) screening discussion by primary care physicians (PCPs) with completion of CRC screening. Study Design: Observational study in Kaiser Permanente Northwest, a group-model health maintenance organization. Methods: A total of 883 participants overdue for CRC screening received an automated telephone call (ATC) between April and June 2009 encouraging CRC screening. Between January and March 2010, participants completed a survey on PCPs' discussion of CRC screening and patient beliefs regarding screening. Primary outcome measure: receipt of CRC screening (assessed by electronic medical record [EMR], 9 months after ATC). Primary independent variable: comprehensiveness of CRC screening discussion by PCPs (7-item scale). Secondary independent variables: perceived benefits of screening (4-item scale assessing respondents' agreement with benefits of timely screening) and primary care utilization (EMR; 9 months after ATC). The independent association of variables with CRC screening was assessed with logistic regression. Results: Average scores for comprehensiveness of CRC discussion and perceived benefits were 0.4 (range 0-1) and 4.0 (range 1-5), respectively. A total of 28.2% (n = 249) completed screening, 84% of whom had survey assessments after their screening date. Of screeners, 95.2% completed the fecal immunochemical test. More comprehensive discussion of CRC screening was associated with increased screening (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.03-2.21). Higher perceived benefits (OR = 1.46, 95% CI = 1.13-1.90) and 1 or more PCP visits (OR = 5.82, 95% CI = 3.87-8.74) were also associated with increased screening. Conclusions: More comprehensive discussion of CRC screening was independently associated with increased CRC screening. Primary care utilization was even more strongly associated with CRC screening, irrespective of discussion of CRC screening.

Original languageEnglish (US)
Pages (from-to)265-271
Number of pages7
JournalAmerican Journal of Managed Care
Volume19
Issue number4
Publication statusPublished - Apr 2013
Externally publishedYes

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ASJC Scopus subject areas

  • Health Policy

Cite this

Mosen, D. M., Feldstein, A. C., Perrin, N. A., Rosales, A. G., Smith, D. H., Liles, E. G., ... Elston-Lafata, J. (2013). More comprehensive discussion of CRC screening associated with higher screening. American Journal of Managed Care, 19(4), 265-271.