We conducted a randomized controlled trial among African-American patients attending a primary-care provider visit to compare efficacy of a computer-delivered tailored intervention to increase colorectal cancer (CRC) screening (n = 273) with non-tailored print material-an American Cancer Society brochure on CRC screening (n = 283). Health Belief Model constructs were used to develop tailored messages and examined as outcomes. Analysis of covariance models were used to compare changes between CRC knowledge and health belief scores at baseline and 1 week post-intervention. At 1 week, patients who received the computer-delivered tailored intervention had greater changes in CRC knowledge scores (P < 0.001), perceived CRC risk scores (P = 0.005), FOBT barriers scores (P = 0.034) and colonoscopy benefit scores (P < 0.001). Findings show that computer-delivered tailored interventions are an effective adjunct to the clinical encounter that can improve knowledge and health beliefs about CRC screening, necessary precursors to behavior change.

Objective To determine the predictors of pain improvement among patients being treated for cancer-related pain over 12 months. Methods A secondary analysis of the Indiana Cancer Pain and Depression (INCPAD) trial was performed. Patients participating in this telephone care management pain and depression intervention trial (N=274, mean age=58.1±10.5 years, 66.1% women) were interviewed at baseline, and 1, 3, 6, and 12 months. Pain improvement outcomes included both a continuous measure (Brief Pain Inventory score) and a categorical measure (pain improved vs. pain not improved). Predictor variables included change in depression, age, gender, race, marital status, socioeconomic disadvantage, medical comorbidity, type of cancer, and phase of cancer. Multivariable repeated measures were conducted adjusting for intervention group assignment, baseline pain severity, and time in months since baseline assessment. Results Factors predicting both continuous and categorical pain improvement included participating in the intervention group (beta=−.92, p<.001; OR=2.53, CI=1.65–3.89), greater improvement in depression (beta=−.31, p=.003; OR=1.84, CI=1.35–2.51), higher socioeconomic status (Socioeconomic Disadvantage Index; beta=.25, p=.034; OR=.73, CI=.56–.94), and fewer comorbid conditions (beta=.20, p=.002; OR=.84, CI=.73–.96). Conversely, patients with more severe pain at baseline or with recurrent or progressive cancer were less likely to experience continuous or categorical pain improvement, respectively. Conclusions Effective management of depression and comorbid conditions along with improvement of social services could be critical components of a comprehensive pain management plan. Also, patients with more severe pain or with recurrent or progressive cancers may require closer monitoring and adequate treatment of pain. Clinical Trial Registration Number NCT00313573