Project Overview +

This project builds on the original ColoWeb project, including updates to content and surveys, and delivering the intervention and surveys to 1,200 patients.

Aims +

Aim 1. Update the existing website with new content and new pre-test and post-test survey questions.

Aim 2. Host the website; ensure secure and efficient log-in and data collection protocols; and monitor, update, and maintain the site.

Aim 3. Deliver the intervention and surveys to 1,200 patients at three UM clinic sites.

Participants +

1200 patients at three different clinic sites at the University of Michigan Health System

Intervention +

This study builds on the original ColoWeb project to better understand how to link a patient using a web-based portal to the University of Michigan clinical data system, CareWeb. Connecting patients and providers in this way offers clinicians information about their patients knowledge, attitudes, and beliefs about cancer control and prevention at the time of their patients visit and ensure that patients receive screening test results, follow-up, and annual reminders in an efficient manner.

ColoWeb is a website that allows for appropriate information from patients to flow directly to clinicians and thus would be immediately available to clinicians at the time of their patient's visit. It also allows appropriate clinical information such as test results to flow efficiently back to patients. This project performs the first linkage between the "patient portal" and the "provider portal" in the area of colon and breast cancer control.

Findings +

"Accuracy of results" was reported most often as important when deciding about CRC screening regardless of screening status. The importance of psychological decisional factors differed significantly by screening status (P<0.05). Among factors interfering with test completion, 38.5% attempting FOBT reported they "forgot" whereas 29.8% attempting colonoscopy were "afraid of pain." Approximately 56.3% indicated a preference for a CRC test: respondents who considered "discomfort" important preferred FOBT (OR: 0.39, 95% CI: 0.17, 0.87); those with a prior colonoscopy preferred an invasive test (OR: 6.50, 95% CI: 2.90, 14.50).

Conclusion +

To improve adherence to CRC screening recommendations, physicians should tailor discussions to patients' prior experiences and test-specific concerns and elicit preferences for screening.