Consistency of Reported Barriers for Colorectal Cancer Screening Among Adults Who Have Never Been Screened

Morbidity and mortality from colorectal cancer can be decreased by addressing patient barriers to colorectal cancer screening; especially among adults who have never been screened. Assessing changes in barriers over time may help practitioners better tailor interventions to address patient barriers. We assessed among adults ages 50 -75 who have never been screened for colorectal cancer (CRC) which barriers predict prospective screening. A sample of 560 adults who had never been screened, recruited from Growth for Knowledge’s online panel, completed a baseline and a six-month follow-up survey. Both surveys assessed screening barriers after an online intervention that involved conveying tailored comparative risk estimates and message framing. Among those who did not get screened, we examined the consistency between reported barriers at baseline and at six-month follow-up. At baseline, participants identified 27 barriers; some reported no barriers. Among those never screened (n = 362), there was a significant increase from baseline to follow-up in five barriers: ‘time/too busy’, ‘no symptoms’, ‘in good health’, ‘no motivation’, and ‘hadn’t thought about it’. Reporting ‘no barriers’ at baseline was a significant predictor of being screened at follow-up (OR = 3.67, 95% CI = 1.44-9.30, p \u3c .007). Among people who have never been screened, interventions should focus on addressing the most consistently reported barriers (i.e., ‘time/too busy’, and on improving knowledge and beliefs about who should be screened and when, as well as attitudes toward screening, to design more efficacious and tailored interventions

Feasibility of a text-based reduction intervention in helping rural and underserved smokeless tobacco users quit

IntroductionSmokeless tobacco (ST) use significantly affects morbidity and mortality and remains disproportionally prevalent in rural and medically underserved communities. Few programs exist for rural smokeless tobacco users. Text-based interventions may increase the reach of cessation interventions; yet, none has tested them in ST users. We evaluated the feasibility, acceptability, and preliminary efficacy of a text-based Scheduled Gradual Reduction (SGR) intervention in rural and underserved ST users.MethodsST users were randomized in 2:1 fashion to the SGR group (N = 65), a text-based reduction program plus text-based support counseling messages or text-based support messages only group (N = 33). We surveyed participants at 30-days post intervention initiation to assess feasibility and acceptability and examined self-report 7-day point prevalence cessation at 30-days and 6-months post intervention initiation in the two arms.ResultsWe achieved benchmarks for feasibility and acceptability. Among the SGR participants 51% (n = 48) reported that intervention was useful in helping them quit, 83% (n = 48) indicated that they would recommend the intervention to a friend. Over 95% (n = 39) of SGR participants said that they read all alert texts. The SGR participants had a higher quit rate at 30-days compared to support messages alone (SGR = 21.5%, Control = 9.1%, p = 0.1627, Cohen's d equivalent = 0.56, medium effect). However, the quit rate at 6-months was 21% (p = 0.9703) for both groups.ConclusionsA text-based intervention was feasible and acceptable among underserved ST users. SGR helped promote short-term cessation. The text-based interventions both had long-term efficacy. Given that text-based interventions have the potential to increase reach in underserved ST users, further testing is warranted

Veritas & Vanitas: A Journal of Creative Nonfiction

A journal of creative nonfiction produced by students at the Marion campus of The Ohio State University with contributions from the students and faculty at the Marion campus of The Ohio State University and Marion Technical College