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Prev Med. 2011 Mar-Apr;52(3-4):262-4. doi: 10.1016/j.ypmed.2011.01.005. Epub 2011 Jan 20.

Race and response to colon cancer screening interventions.

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Thomas Jefferson University, Division of Gastroenterology, Department of Internal Medicine, Philadelphia, PA 19107, USA.



We report race-related differences in response to behavioral interventions in colorectal cancer (CRC) screening.


From 2002 through 2005, a total of 1430 primary care patients (578 whites and 852 African Americans) from Jefferson Family Medicine Associates, a large primary care practice affiliated with Thomas Jefferson University, completed a baseline survey and were randomized to 1 of 4 groups, as follows: control (usual care), standard intervention (SI), tailored intervention (TI), or tailored intervention plus phone (TIP). The SI group received a targeted print intervention by mail. The TI group received the targeted intervention and tailored message pages that addressed perceptions related to screening. The TIP group received the targeted intervention, tailored message pages, and a telephone reminder.


CRC screening rates for whites and African Americans were comparable in usual care (33% versus 32%, respectively). In response to intervention, however, whites exhibited significantly higher (p=0.005) screening rates than African Americans (53% versus 43%, respectively; adjusted OR=1.44; 95% CI=1.12-1.86). This effect is largely explained by differential response to mailed print interventions.


Whites and African Americans may respond differently to mailed interventions intended to increase CRC screening. Research is needed on methods that can both increase screening and racial equity in screening.

[Indexed for MEDLINE]

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