Interactive Computer Program or Brochure in Increasing Colorectal Cancer Screening Among African Americans (PACT)

• Self-reported colorectal cancer (CRC) screening adherence with medical record verification of screening test completion [ Time Frame: 6 and 15 months post-intervention ] [ Designated as safety issue: No ]
  

• Self-reported CRC discussion and screening test recommendation from provider on intervention/clinic visit date [ Time Frame: 1 week post-intervention ] [ Designated as safety issue: No ]
  Discussion of FOBT, colonoscopy, and sigmoidoscopy is assessed. Particpants report on whether or not an FOBT kit was given to them during this visit. Additionally, participants report on whether or not someone in the doctor's office made an appointment for a colonoscopy or sigmoidoscopy.
  
  
• Provider documentation of CRC discussion and screening test recommendation on intervention/clinic visit date [ Time Frame: 1 week post-intervention ] [ Designated as safety issue: No ]
  Medical record documentation of discussion of FOBT, providing participant with an FOBT kit, discussion and/or ordering a colonoscopy, and discussion and/or ordering a sigmoidoscopy is assessed.
  
  
• Self-reported CRC health beliefs [ Time Frame: Pre-intervention (baseline),1 week post-intervention, and 6 months post-intervention ] [ Designated as safety issue: No ]
  Changes in perceived risk, benefits to screening, barriers to screening, and self-efficacy for CRC screening are assessed.
  
  
• Self-reported stage of CRC screening test adoption [ Time Frame: Pre-intervention (baseline),1 week post-intervention, 6 months post-intervention, and 15 months post-intervention ] [ Designated as safety issue: No ]
  For FOBT, colonoscopy, and sigmoidoscopy, stage of adoption measured as either precontemplation, contemplation, preparation, action, or maintenance.
  
  

• Patient characteristics as CRC screening predictors [ Time Frame: Pre-intervention (baseline), intervention date, 1 week post-intervention, 6 months post-intervention, and/or 15 months post-intervention ] [ Designated as safety issue: No ]
  Age, gender, marital status, education, health literacy, income, employment, insurance coverage, BMI, co-morbidities, family history of cancer, family or friend encouragement to have CRC screening, CRC knowledge, physician trust, fatalism views, and health temporal orientation are assessed.
  
  
• Clinic variables as CRC screening predictors [ Time Frame: Pre-intervention (baseline), 1 week post-intervention, 6 months post-intervention, and 15 months post-intervention ] [ Designated as safety issue: No ]
  Clinic site, participant's reason for health care provider visit, and prior recommendation(s) to do CRC screening are assessed.
  
  

OBJECTIVES:

• Compare rates of participation in fecal occult blood testing and endoscopic screening (colonoscopy or sigmoidoscopy) among African-Americans who receive an interactive computer intervention (ICI) versus a non-tailored colorectal cancer screening brochure.
• Examine mediators and moderators of intervention effectiveness as depicted in the conceptual model.

OUTLINE: This is a multicenter study.

Participants are stratified according to site, age (≤ 65 years old vs > 65 years old) and gender. Participants are randomized to one of two arms.

• Arm I (non-tailored colorectal cancer screening brochure): Participants undergo a baseline interview via telephone and receive a colorectal cancer screening brochure in the clinic prior to visit with healthcare provider. Participants then undergo telephone interviews at 1 week, 6 months, and 15 months.
• Arm II (interactive computer intervention [ICI]): Participants undergo a baseline interview via telephone and complete an ICI in the clinic prior to visit with healthcare provider. Participants then undergo telephone interviews at 1 week, 6 months, and 15 months.