TY - JOUR
T1 - Factors associated with colorectal cancer screening among a low-income, multiethnic, highly insured population
T2 - Does provider's understanding of the patient's social context matter?
AU - De Jesus, Maria
AU - Puleo, Elaine
AU - Shelton, Rachel C.
AU - McNeill, Lorna H.
AU - Emmons, Karen M.
N1 - Funding Information:
This research was supported by grants 5R01CA098864-02, 1K22CA126992-01, and K05 CA124415 from the National Cancer Institute and support to the Dana-Farber Cancer Institute by Liberty Mutual, National Grid, the Patterson Fellowship, and the Yerby Fellowship Program.
PY - 2010/3
Y1 - 2010/3
N2 - The primary aim of this paper was to explore whether provider's understanding of patient's social context is associated with screening uptake, independent of provider's recommendation. Baseline data were collected in 2004-2005 from a cluster randomized control trial in 12 low-income housing sites. Participants included 695 low- income, multiethnic adults aged 50 years and over who were primarily insured (97%). Provider s recommendation was significantly associated with current adherence to colorectal cancer (CRC) screening. Provider's understanding of patient's social context, as operationalized by how well participants felt that their provider knew (a) their responsibilities at work, home, or school; (b) their worries about health; and (c) them as a person and their values and beliefs, was also significantly associated with current adherence to screening, independent of provider s recommendation. Participants who reported that their provider knew them well on two or three items were significantly more likely to be current with CRC screening compared to those who reported their provider knew them well on only one or none of the items (odds ratio = 1.56; 95% confidence interval=1.06, 2.29). Our findings indicate that provider's understanding of patient's social context, independent of provider's recommendation for CRC screening, contributed to adherence to CRC screening in this low-income, multiethnic population.
AB - The primary aim of this paper was to explore whether provider's understanding of patient's social context is associated with screening uptake, independent of provider's recommendation. Baseline data were collected in 2004-2005 from a cluster randomized control trial in 12 low-income housing sites. Participants included 695 low- income, multiethnic adults aged 50 years and over who were primarily insured (97%). Provider s recommendation was significantly associated with current adherence to colorectal cancer (CRC) screening. Provider's understanding of patient's social context, as operationalized by how well participants felt that their provider knew (a) their responsibilities at work, home, or school; (b) their worries about health; and (c) them as a person and their values and beliefs, was also significantly associated with current adherence to screening, independent of provider s recommendation. Participants who reported that their provider knew them well on two or three items were significantly more likely to be current with CRC screening compared to those who reported their provider knew them well on only one or none of the items (odds ratio = 1.56; 95% confidence interval=1.06, 2.29). Our findings indicate that provider's understanding of patient's social context, independent of provider's recommendation for CRC screening, contributed to adherence to CRC screening in this low-income, multiethnic population.
KW - Colorectal cancer
KW - Provider's recommendation for CRC screening
KW - Social context
KW - Urban low-income population
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U2 - 10.1007/s11524-009-9420-1
DO - 10.1007/s11524-009-9420-1
M3 - Article
C2 - 20043214
AN - SCOPUS:77953666449
SN - 1099-3460
VL - 87
SP - 236
EP - 243
JO - Journal of Urban Health
JF - Journal of Urban Health
IS - 2
ER -