Correlates of Patient Intent and Preference on Colorectal Cancer Screening

Masahito Jimbo, Ananda Sen, Melissa A. Plegue, Sarah T. Hawley, Karen Kelly-Blake, Mary Rapai, Minling Zhang, Yuhong Zhang, Mack T. Ruffin

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Introduction Information is limited on patient characteristics that influence their preference among screening options and intent to be screened for colorectal cancer (CRC). A mechanistic pathway to intent and preference was examined through a formal mediation analysis. Methods From 2012 to 2014, a total of 570 adults aged 50–75 years were recruited from 15 primary care practices in Metro Detroit for a trial on decision aids for CRC screening. Confirmatory factor, regression, and mediation analyses were performed in 2015–2016 on baseline cross-sectional data. Main outcomes were patient intent and preference. Perceived risk and self-efficacy were secondary outcomes. Covariates included demographic information, health status, previous CRC screening experience, patient attitudes, and knowledge. Results Mean age was 57.7 years, 56.1% were women, and 55.1% white and 36.6% black. Women had 32% and 41% lower odds than men of perceiving CRC to be high/moderate risk (OR=0.68, 95% CI=0.47, 0.97, p=0.03) and having high self-efficacy (OR=0.59, 95% CI=0.42, 0.85, p=0.006), respectively. Whites had 63% and 47% lower odds than blacks of having high self-efficacy (OR=0.37, 95% CI=0.25, 0.57, p<0.001) and intent to undergo CRC screening (OR=0.53, 95% CI=0.34, 0.84, p=0.007), respectively. Younger age, higher knowledge, lower level of test worries, and medium/high versus low self-efficacy increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent. Conclusions Self-efficacy mediated the association between race, attitude, and test worries and patient intent.

Original languageEnglish (US)
Pages (from-to)443-450
Number of pages8
JournalAmerican Journal of Preventive Medicine
Issue number4
StatePublished - Apr 1 2017

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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