A randomized trial of two print interventions to increase colon cancer screening among first-degree relatives

Patient Educ Couns. 2008 May;71(2):215-27. doi: 10.1016/j.pec.2008.01.013. Epub 2008 Mar 4.


Objective: First-degree relatives (FDRs) of people diagnosed with colorectal cancer (CRC) have a two- to threefold increased risk of developing the same disease. Tailored print interventions based on behavior change theories have demonstrated considerable promise in facilitating health-promoting behaviors. This study compared the impact of two mailed print interventions on CRC screening outcomes among FDRs.

Methods: This randomized trial compared effects of two mailed print interventions--one tailored and one nontailored--on participation in CRC screening among FDRs of CRC survivors. Data collected via phone interviews from 140 FDRs at baseline, 1 week post-intervention, and 3 months post-intervention.

Results: At 3 months, both the tailored and nontailored interventions yielded modest but statistically insignificant increases in adherence to any CRC screening test (14% vs. 21%, respectively; p=0.30). While there were no main effects for tailored versus nontailored interventions, there were significant interactions that showed that the tailored print intervention had significantly greater effects on forward stage movement for CRC screening depending on stage of adoption at baseline, race, and objective CRC risk. Receipt of the tailored intervention was 2.5 times more likely to move baseline precontemplators and contemplators forward in stage of adoption for colonoscopy (95% CI: 1.10-5.68) and was three times more likely to move Caucasians forward in stage of adoption for FOBT (95% CI: 1.00-9.07). In addition, the tailored intervention was 7.7 times more likely to move people at average risk forward in stage of adoption for colonoscopy (95% CI: 1.25-47.75).

Conclusion: The tailored print intervention was more effective at moving Caucasians, those in precontemplation and contemplation at baseline, and those at average risk forward in their stage of adoption for CRC screening.

Practice implications: Both tailored and nontailored print interventions showed moderate effects for increasing CRC screening participation. Tailored print interventions may be more effective for certain subgroups.

Publication types

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

MeSH terms

  • African Americans / education
  • African Americans / psychology
  • Analysis of Variance
  • Colorectal Neoplasms / epidemiology
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / prevention & control*
  • Family / psychology*
  • Female
  • Follow-Up Studies
  • Health Education / organization & administration*
  • Health Knowledge, Attitudes, Practice
  • Health Services Needs and Demand
  • Humans
  • Male
  • Mass Screening / methods
  • Mass Screening / psychology*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Models, Psychological
  • Patient Care Planning
  • Patient Compliance / psychology*
  • Patient Compliance / statistics & numerical data
  • Pedigree
  • Risk Factors
  • Surveys and Questionnaires
  • Teaching Materials / standards*
  • Whites / education
  • Whites / psychology