Shared decision-making about colorectal cancer screening: A conceptual framework to guide research

Christy, Shannon M.; Rawl, Susan M.

doi:10.1016/j.pec.2013.01.015

Cited by 12 publications

(12 citation statements)

References 110 publications

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“…Our study is among the first studies to measure both “informed” and “joint” dimensions of the SDM, as suggested by the USPSTF, between healthcare professionals and patients. Several clinical trials have used the SDM framework to explain the screening decisions on prostate cancer [ 24 , 25 ], colorectal cancer [ 26 ], and breast cancer [ 27 ], but they only focused on the information exchange aspect of the SDM by using the decision aids as an intervention (e.g., educational videotape). In other words, the studies actually measured the concept of informed decision-making instead of the SDM.…”

Section: Discussionmentioning

confidence: 99%

Shared Decision-Making and Women’s Adherence to Breast and Cervical Cancer Screenings

Han

Jungsuwadee

Abraham

et al. 2018

IJERPH

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We examined the effect of shared decision-making (SDM) on women’s adherence to breast and cervical cancer screenings and estimated the prevalence and adherence rate of screenings. The study used a descriptive cross-sectional design using the 2017 Health Information National Trends Survey (HINTS) data collected by the National Cancer Institute. Adherence was defined based on the guidelines from the American Cancer Society and the composite measure of shared decision-making was constructed using three items in the data. Multivariable logistic regression was performed to examine the association between the SDM and adherence, controlling for cancer beliefs and socio-demographic variables. The analysis included 742 responses. Weighted to represent the U.S. population, 68.1% adhered to both breast and cervical cancer screening guidelines. The composite measure of SDM was reliable (α = 0.85), and a higher SDM score was associated with women’s screening adherence (b = 0.17; p = 0.009). There were still women who did not receive cancer screenings as recommended. The results suggest that the use of the SDM approach for healthcare professionals’ communication with patients can improve screening adherence.

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Section: Discussionmentioning

confidence: 99%

Shared Decision-Making and Women’s Adherence to Breast and Cervical Cancer Screenings

Han

Jungsuwadee

Abraham

et al. 2018

IJERPH

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“…(23). Tools that facilitate patient preference clarification can help to engage patients and their providers (or agents, such as patient navigators) in shared decision making about screening (24). Systematic reviews have identified few randomized controlled trials of colorectal cancer screening interventions among Hispanics (15,25), and none has used patient preference elicitation and decision support as part of the intervention strategy.…”

Section: Introductionmentioning

confidence: 99%

Decision Support and Navigation to Increase Colorectal Cancer Screening Among Hispanic Patients

Myers

Stello

Daskalakis

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Effective strategies are needed to raise colorectal cancer screening rates among Hispanics. Methods: We surveyed and randomized 400 Hispanic primary care patients either to a Decision Support and Navigation Intervention (DSNI) Group (n ¼ 197) or a Standard Intervention (SI) Group (n ¼ 203). Both groups received a colorectal cancer screening kit [bilingual informational booklet, fecal immunochemical stool blood test (SBT), and colonoscopy screening instructions]. The DSNI Group received a telephone contact from a patient navigator. The navigator clarified screening test preference and likelihood of test performance, helped to develop a screening plan, and provided guidance through test performance. An endpoint telephone survey and medical chart review were completed. Multivariable analyses were conducted to assess 12-month screening adherence, change in decision stage, and knowledge and perceptions. Results: Screening adherence was significantly higher in the DSNI Group than the SI Group [OR, 4.8; 95% confidence interval (CI), 3.1-7.6]. The DSNI Group, compared with the SI Group, also displayed higher SBT screening [OR, 4.2; 95% CI, 2.6-6.7), higher colonoscopy screening (OR, 8.8; 95% CI, 4.1-18.7), and greater forward change in screening decision stage (OR, 4.9; 95% CI, 2.6-9.5). At endpoint, study groups did not differ in screening knowledge or perceptions. Conclusions: The DSNI had a greater positive impact on colorectal cancer screening outcomes than the SI. Impact: Health system implementation of DSNI strategies may help to reduce Hispanic colorectal cancer screening disparities in primary care.

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“…The Health Belief Model is a commonly used framework to explain cancer screening behavior and posits that education and knowledge may modify the pathway between individual perceptions (eg, perceived susceptibility of the disease) and behavior. 33 The clinician plays a key role in patient behavior through advising, communicating, and educating the patient. Clinician-patient interactions regarding preventive services should follow the 5A's: assess, advise, agree, assist, and arrange.…”

Section: Discussionmentioning

confidence: 99%

“…Education for the patient on the benefits, harms, and alternatives for each colorectal cancer screening modality may engage patients in the shared decision making process and increase screening adherence, particularly for race/ ethnic minority patients. 33 Recent evidence suggests that colorectal cancer mortality has increased since 2005 among those aged 40 to 54 years, 35 and in May 2018, the American Cancer Society expanded its colorectal cancer screening recommendations to begin screening at 45 years of age. 36 In our study of patients aged Ն50 years, younger individuals appeared to be at a marginally increased risk of FIT return failure, and although results were not statistically significant, this is consistent with other recent work 13 and troubling in light of trend data.…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators of Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC)

et al. 2019

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Introduction:Colorectal cancer is a leading cause of cancer-related mortality in the United States. Current screening recommendations for individuals aged 50 to 75 years include colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, or annual stool-based testing. Stool-based testing, including fecal immunochemical tests (FITs), are cost effective, easy to perform at home, and noninvasive, yet many patients fail to return testing kits and go unscreened. The purpose of the study was to identify patient characteristics and perceived barriers and facilitators of FIT return.Methods: Patients in a large, federally qualified health center who received a FIT kit order between January 1 and July 1, 2017 were identified. We compared sociodemographic and health characteristics between patients who returned and did not return FITs. We used telephone surveys to nonreturners to identify potential barriers (cost, knowledge, psychosocial factors) and facilitators (prepaid postage, outreach) of FIT kit return. An online survey of clinicians assessed perceived patient barriers and facilitators of colorectal cancer screening.Results: Of the 875 patients who received a FIT order, 435 (49.7%) did not return the kit and 121 of the nonreturners completed a telephone survey. Current smokers had an increased risk of FIT nonreturn compared with never smokers (RR ‫؍‬ 1.32; 95% CI, 1.13-1.54). Forgetfulness and lack of motivation were the most common FIT return barriers perceived by both patients and clinicians. Prepaid postage with return address on FIT return envelopes and live call reminders were the most commonly reported facilitators. Barriers and facilitators varied greatest between English-and Spanish-speaking patients.Conclusion: In this study, the most common perceived barriers to return of screening fecal test kits were forgetfulness and lack of motivation. The most common perceived facilitators were live call reminders and postage-paid return envelopes. Understanding barriers and facilitators to FITs may be necessary to enhance cancer screening rates in underserved patient populations. (J Am Board Fam Med 2019;32:180 -190.)Colorectal cancer is the second most common type of cancer-related death in men and the third most common in women; over 50,000 deaths a year in the United States are attributable to colorectal cancer. 1 Although substantial progress was made over the past 2 decades and colorectal cancer death rates This article was externally peer reviewed.

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Shared decision-making about colorectal cancer screening: A conceptual framework to guide research

Cited by 12 publications

References 110 publications

Shared Decision-Making and Women’s Adherence to Breast and Cervical Cancer Screenings

Shared Decision-Making and Women’s Adherence to Breast and Cervical Cancer Screenings

Decision Support and Navigation to Increase Colorectal Cancer Screening Among Hispanic Patients

Barriers and Facilitators of Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC)

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