Implementation intentions and colorectal screening: a randomized trial in safety-net clinics

Area of Science:

• Public Health
• Behavioral Science
• Cancer Prevention

Background:

• Low-income and minority populations face higher colorectal cancer (CRC) burdens and poorer survival rates.
• There is a critical need for novel behavioral strategies to enhance CRC screening in these vulnerable groups.

Purpose of the Study:

• To evaluate an "implementation intentions" intervention designed to improve CRC screening among unscreened adults in urban safety-net clinics.
• To test a theoretically based approach for increasing adherence to CRC screening protocols.

Main Methods:

• A randomized controlled trial involving 470 adults aged 50 years and older from urban safety-net clinics.
• Participants received either generic health information or an "implementation intentions" intervention via touchscreen computers, tailored to their needs.
• The primary outcome was CRC screening completion at 26 weeks, assessed via test reports.

Main Results:

• The implementation intentions group showed significantly higher odds of completing CRC screening compared to the control group (AOR=1.83).
• Factors associated with increased screening completion included higher self-efficacy, history of asthma, no history of diabetes, and specific knowledge about cancer.
• The study population was diverse, with a mean age of 57, and included significant proportions of non-Hispanic African American and Hispanic individuals.

Conclusions:

• An implementation intentions-based intervention is effective in promoting CRC screening completion among diverse, low-income populations.
• This approach holds potential for large-scale initiatives aimed at reducing CRC incidence and mortality disparities.
• Future public health efforts can leverage implementation intentions to encourage cancer screening and prevention behaviors.