268561 Predictors of Positive Colonoscopy Expectations among Patients in the Rural South Pathway for Disparities?

Monday, October 29, 2012

Barbara Curbow, PhD , Behavioral Science and Community Health, University of Florida, Gainesville, FL
Tracey E. Barnett, PhD , Department of Behavioral Science and Community Health, University of Florida, Gainesville, FL
Amy Dailey, PhD, MPH , Health Sciences Department, Gettysburg College, Gettysburg, PA
Thomas George Jr., MD , Department of Medicine, University of Florida, Gainesville, FL
Evelyn King-Marshall, MPH , Department of Behavioral Science Community Health, University of Florida, Gainesville, FL
Emmett Martin, MPH, BA , Department of Behavioral Science Community Health, Unversity of Florida, Gainesville, FL
Jane McGinley, BA , College of Medicine, University of Florida, Gainesville, FL
Elisa Rodriguez, PhD, MS , Behavioral Science and Community Health, University of Florida, College of Public Health and Health Professions, Gainesville, FL
Jessica Schumacher, PhD , Health Services Research, Management, and Policy, University of Florida, Gainesville, FL
Shanaz Sultan, MD , Department of Medicine, University of Florida, Gainesville, FL
Britany Telford, BS , Dept. Behavioral Science and Community Health, Unversity of Florida, Gainesville, FL
Colorectal screenings, used to detect and remove pre-cancerous polyps are usually recommended every 10 years. Overall, 58.6% of adults are up-to-date with their colorectal screening, compared to the Healthy People 2020 target of 70.5%. Screening rates remain lower among some subgroups: immigrants, low income, low education, lacking insurance, and lacking a usual source of care. From an ongoing study of 4300 colonoscopy patients and caregivers, data are reported on the first 290 patients and caregivers enrolled; participants completed a survey pre-colonoscopy including items on their expectations regarding the procedure. Additionally, caregivers completed a brief post-colonoscopy survey on actual outcomes. Patients were predominantly female, White, middle- aged, employed, educated, married/partnered, with a range of incomes. Most patients (54%) expected the physician would personally tell them the results immediately post-procedure and that he/she would spend an average of 7.8 and 7.6 minutes with them pre and post procedure. Post-tests indicated that physicians gave results only 24% of the time and spent an average of 4 minutes with those patients. Multiple regression findings indicated significant associations: (1) expecting results from physician and younger age; (2) greater time with physican pre-procedure and lower education, nonwhite race, lower income, and lower perceptions of physician discrimination; (3) greater time with physican post-procedure and nonwhite race, lower income, and lower physician discrimination. At-risk patients may have higher expectations for physican treatment pre- and post-colonoscopy. To the extent that expectations are not met, future screening behaviors may be affected negatively, thus presenting an avenue for health disparities.

Learning Areas:
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Diversity and culture
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
Describe the predictors of postive expectations associated with colonoscopy. Discuss the possible relationship between overly optimistic expectations and future behaviors.

Keywords: Cancer Screening, Health Disparities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a professor of public health for 25 years and am actively engaged in public health research and teaching.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.