Effects of tailored knowledge enhancement on colorectal cancer screening preference across ethnic and language groups

ObjectiveTailoring to psychological constructs (e.g. self-efficacy, readiness) motivates behavior change, but whether knowledge tailoring alone changes healthcare preferences – a precursor of behavior change in some studies – is unknown. We examined this issue in secondary analyses from a randomized controlled trial of a tailored colorectal cancer (CRC) screening intervention, stratified by ethnicity/language subgroups (Hispanic/Spanish, Hispanic/English, non-Hispanic/English).MethodsLogistic regressions compared effects of a CRC screening knowledge-tailored intervention versus a non-tailored control on preferences for specific test options (fecal occult blood or colonoscopy), in the entire sample (N = 1164) and the three ethnicity/language subgroups.ResultsPre-intervention, preferences for specific tests did not differ significantly between study groups (experimental, 64.5%; control 62.6%). Post-intervention, more experimental participants (78.6%) than control participants (67.7%) preferred specific tests (P < 0.001). Adjusting for pre-intervention preferences, more experimental group participants than control group participants preferred specific tests post-intervention [average marginal effect (AME) = 9.5%, 95% CI 5.3–13.6; P < 0.001]. AMEs were similar across ethnicity/language subgroups.ConclusionKnowledge tailoring increased preferences for specific CRC screening tests across ethnic and language groups.Practice ImplicationsIf the observed preference changes are found to translate into behavior changes, then knowledge tailoring alone may enhance healthy behaviors.