• Masahito Jimbo, Ananda Sen, Melissa A Plegue, Sarah T Hawley, Karen Kelly-Blake, Mary Rapai, Minling Zhang, Yuhong Zhang, and Mack T Ruffin.
• Department of Family Medicine, University of Michigan, Ann Arbor, Michigan.
• Am J Prev Med. 2017 Apr 1; 52 (4): 443-450.

IntroductionInformation is limited on patient characteristics that influence their preference among screening options and intent to be screened for colorectal cancer (CRC). A mechanistic pathway to intent and preference was examined through a formal mediation analysis.MethodsFrom 2012 to 2014, a total of 570 adults aged 50-75 years were recruited from 15 primary care practices in Metro Detroit for a trial on decision aids for CRC screening. Confirmatory factor, regression, and mediation analyses were performed in 2015-2016 on baseline cross-sectional data. Main outcomes were patient intent and preference. Perceived risk and self-efficacy were secondary outcomes. Covariates included demographic information, health status, previous CRC screening experience, patient attitudes, and knowledge.ResultsMean age was 57.7 years, 56.1% were women, and 55.1% white and 36.6% black. Women had 32% and 41% lower odds than men of perceiving CRC to be high/moderate risk (OR=0.68, 95% CI=0.47, 0.97, p=0.03) and having high self-efficacy (OR=0.59, 95% CI=0.42, 0.85, p=0.006), respectively. Whites had 63% and 47% lower odds than blacks of having high self-efficacy (OR=0.37, 95% CI=0.25, 0.57, p<0.001) and intent to undergo CRC screening (OR=0.53, 95% CI=0.34, 0.84, p=0.007), respectively. Younger age, higher knowledge, lower level of test worries, and medium/high versus low self-efficacy increased the odds of intent of being screened. Self-efficacy, but not perceived risk, significantly mediated the association between race, attitude, and test worries and patient screening intent.ConclusionsSelf-efficacy mediated the association between race, attitude, and test worries and patient intent.Copyright © 2017. Published by Elsevier Inc.

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