The Effects of Tailoring Knowledge Acquisition on Colorectal Cancer Screening Self-Efficacy

Abstract

Interventions tailored to psychological factors such as personal and vicarious behavioral experiences can enhance behavioral self-efficacy but are complex to develop and implement. Information seeking theory suggests tailoring acquisition of health knowledge (without concurrent psychological factor tailoring) could enhance self-efficacy, simplifying the design of tailored behavior change interventions. To begin to examine this issue, the authors conducted exploratory analyses of data from a randomized controlled trial, comparing the effects of an experimental colorectal cancer screening intervention tailoring knowledge acquisition with the effects of a nontailored control on colorectal cancer screening knowledge and self-efficacy in 1159 patients comprising three ethnicity/language strata (Hispanic/Spanish, 23.4%, Hispanic/English, 27.2%, non-Hispanic/English, 49.3%) and 5 recruitment center strata. Adjusted for study strata, the mean postintervention knowledge score was significantly higher in the experimental group than in the control group. Adjusted experimental intervention exposure (B = 0.22, 95% CI [0.14, 0.30]), preintervention knowledge (B = 0.11, 95% CI [0.05, 0.16]), and postintervention knowledge (B = 0.03, 95% CI [0.01, 0.05]) were independently associated with subsequent colorectal cancer screening self-efficacy (p < .001 all associations). These exploratory findings suggest that tailoring knowledge acquisition may enhance self-efficacy, with potential implications for tailored intervention design, but this implication requires confirmation in studies specifically designed to examine this issue.

Acknowledgments

The authors are grateful to the following individuals, who facilitated recruitment and participation of patients in the study: Dionne Evans-Dean, MHA, Dustin Gottfeld, BS, and Lizette Macias, BS (Sacramento, California); Mechelle R. Sanders, BA and Leticia E. Serrano, AAS (Rochester, New York); Sandra Monroy, MA (The Bronx, New York); Brandon Tutt, MA (Denver, Colorado); and Raquel Romero, MD, MPH (San Antonio, Texas). The authors also thank Charles Turner, PhD, Simon Dvorak, BA, and Robert Burnett, MA, for their programming contributions to the tailored software program. The authors are also indebted to all of the primary care offices and patients who participated.