Ca ncer Scr ee ni ng A dh er en ce th r ou gh Te ch no lo gy -e nh a nced Sh a r ed De cis io n M a k in g (C SA TS )
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Cancer Screening Adherence through Technology-enhanced Shared Decision Making (CSATS)

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Cancer Screening Adherence through Technology-enhanced Shared Decision Making (CSATS)

  1. 1. Ca ncer Scr ee ni ng A dh er en ce th r ou gh Te ch no lo gy -e nh a nced Sh a r ed De cis io n M a k in g (C SA TS ) M a s a h ito J im b o 1 , M a ck R u ffin 1 , Do n a ld N e a s e 1 , M ich a e l Fe tte r s 1 , V icto r S tr e ch e r 2 , Ed w a r d S a u n d e r s 2 1 : U n iv e r s ity o f M ich ig a n De p a r tm e n t o f Fa m ily M e d icin e ; 2 : U n iv e r s ity o f M ich ig a n Ce n te r fo r H e a lth Co m m u n ica tio n R e s e a r ch Co lo r e cta l W e b : Co n ce p tu a l M o d e l Co lo r e cta l W e b B a ck g r o u n d Phy sicia n a nd pa tient reminder sy stems modestly Combina tion of Ela bora tion Lik elihood M odel a nd Theory of Pla nned Beha vior. increa se colorecta l ca ncer (CRC) screening ra te. Decision 1. Ela bora tion Lik elihood M odel a ids a nd ta ilored beha viora l interventions ha ve ha d - Centra l processing: People a re more lik ely to be persua ded if they ca n ela bora te ex tensively on a messa ge. va ria ble success, but genera lly ha ve not been delivered - Periphera l processing: People ma y be persua ded tempora rily by fa ctors tha t ha ve nothing do w ith the a ctua l by the pa tient's prima ry ca re phy sicia n (PCP), not content of the messa ge. ca pita lizing on the evidence tha t phy sicia n a . Informa tion on Colorecta l W eb motiva tes the user to ela bora te a nd process centra lly . recommenda tion cha nges pa tient beha vior. b. Intera ctive ex pla na tions a nd tools in Colorecta l W eb ena ble the user to ela bora te rela tively ea sily . c. The intera ctive na ture of the tools ma y a lso cue the user through the periphera l route. 2. Theory of Pla nned Beha vior O b je ctiv e - Beha vior is determined by intention to perform the beha vior. - Intention = Attitude x Subjective norm x Perceived beha viora l control - The theory ha s held up w ell in situa tions w here a person needs to ma k e volunta ry choices. To develop a nd test the fea sibility of Ca ncer Screening Adherence through Technology -enha nced Sha red Decision M a k ing (CSATS), a beha viora l intervention model to improve CRC screening tha t link s A ttitudes P r efer ence Selection the follow ing to enha nce Sha red Decision M a k ing (SDM ) betw een the pa tient a nd the phy sicia n: Intent P er ceiv ed 1. Colorecta l W eb: a beha viora l intervention tha t Decision A id B eha v ior a l (Color ecta l W eb) combines decision a id a nd risk a ssessment. Contr ol 2. ClinfoTra ck er: a computer prompt/ reminder sy stem. Infor m a tion P r ocessing Subjectiv e (Ela bor a tion) 3. Phy sicia n recommenda tion. N or m Sha r ed Decision M a k ing B eha v ior Clarification of COLORECTAL WEB Shared patient risk and Decision aid Decision preferences O n g o in g Fe a s ib ility S tu d y on risk Making and preference Setting: 2 university -a ffilia ted fa mily medicine pra ctices. LINK Pa tients: 20 pa tients a ged 5 0 to 74 y ea rs. Intervention: - Before the pla nned hea lth ma intena nce visit, consenting pa tients identified by ClinfoTra ck er a s due for CRC ClinfoTracker screening w ill securely log in to Colorecta l W eb a nd complete the intera ctive risk a nd preference survey s. Physician Reminder - W hen the pa tients a rrive, phy sicia ns w ill receive CRC screening reminder a nd risk / preference survey results. (Can import data set - Phy sicia ns w ill use this informa tion to fa cilita te CRC screening discussion. from any software) M a in a nd Seconda ry O utcome M ea sures: Q ua ntita tive a nd qua lita tive descriptive process outcomes obta ined through Colorecta l W eb da ta retrieva l, pa tient telephone interview s, visit a udiota pes, a nd pa tient a nd phy sicia n survey s. (Before Visit) (At Visit) - The ea se a nd usefulness of Colorecta l W eb - The effect of CSATS on the w ork flow of PCP pra ctices a nd the process of SDM rega rding CRC screening - Pa tient k now ledge, a ttitide, decisiona l conflict/ sa tisfa ction, a nd a ctua l CRC screening ra te.

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