TY - JOUR
T1 - Telehealth and racial disparities in colorectal cancer screening
T2 - A pilot study of how virtual clinician characteristics influence screening intentions
AU - Cooks, Eric J.
AU - Duke, Kyle A.
AU - Neil, Jordan M.
AU - Vilaro, Melissa J.
AU - Wilson-Howard, Danyell
AU - Modave, Francois
AU - George, Thomas J.
AU - Odedina, Folakemi T.
AU - Lok, Benjamin C.
AU - Carek, Peter
AU - Laber, Eric B.
AU - Davidian, Marie
AU - Krieger, Janice L.
N1 - Publisher Copyright:
© 2022 Cambridge University Press. All rights reserved.
PY - 2022/4/8
Y1 - 2022/4/8
N2 - Introduction: Racial disparities in colorectal cancer (CRC) can be addressed through increased adherence to screening guidelines. In real-life encounters, patients may be more willing to follow screening recommendations delivered by a race concordant clinician. The growth of telehealth to deliver care provides an opportunity to explore whether these effects translate to a virtual setting. The primary purpose of this pilot study is to explore the relationships between virtual clinician (VC) characteristics and CRC screening intentions after engagement with a telehealth intervention leveraging technology to deliver tailored CRC prevention messaging. Methods: Using a posttest-only design with three factors (VC race-matching, VC gender, intervention type), participants (N = 2267) were randomised to one of eight intervention treatments. Participants self-reported perceptions and behavioral intentions. Results: The benefits of matching participants with a racially similar VC trended positive but did not reach statistical significance. Specifically, race-matching positively influenced screening intentions for Black participants but not for Whites (b = 0.29, p = 0.10). Importantly, perceptions of credibility, attractiveness, and message relevance significantly influenced screening intentions and the relationship with race-matching. Conclusions: To reduce racial CRC screening disparities, investments are needed to identify patient-focused interventions to address structural barriers to screening. This study suggests that telehealth interventions that match Black patients with a Black VC can enhance perceptions of credibility and message relevance, which may then improve screening intentions. Future research is needed to examine how to increase VC credibility and attractiveness, as well as message relevance without race-matching.
AB - Introduction: Racial disparities in colorectal cancer (CRC) can be addressed through increased adherence to screening guidelines. In real-life encounters, patients may be more willing to follow screening recommendations delivered by a race concordant clinician. The growth of telehealth to deliver care provides an opportunity to explore whether these effects translate to a virtual setting. The primary purpose of this pilot study is to explore the relationships between virtual clinician (VC) characteristics and CRC screening intentions after engagement with a telehealth intervention leveraging technology to deliver tailored CRC prevention messaging. Methods: Using a posttest-only design with three factors (VC race-matching, VC gender, intervention type), participants (N = 2267) were randomised to one of eight intervention treatments. Participants self-reported perceptions and behavioral intentions. Results: The benefits of matching participants with a racially similar VC trended positive but did not reach statistical significance. Specifically, race-matching positively influenced screening intentions for Black participants but not for Whites (b = 0.29, p = 0.10). Importantly, perceptions of credibility, attractiveness, and message relevance significantly influenced screening intentions and the relationship with race-matching. Conclusions: To reduce racial CRC screening disparities, investments are needed to identify patient-focused interventions to address structural barriers to screening. This study suggests that telehealth interventions that match Black patients with a Black VC can enhance perceptions of credibility and message relevance, which may then improve screening intentions. Future research is needed to examine how to increase VC credibility and attractiveness, as well as message relevance without race-matching.
KW - Cancer health disparities
KW - colorectal cancer screening
KW - precision prevention
KW - telehealth
KW - virtual human technology
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U2 - 10.1017/cts.2022.386
DO - 10.1017/cts.2022.386
M3 - Article
AN - SCOPUS:85128544609
SN - 2059-8661
VL - 6
JO - Journal of Clinical and Translational Science
JF - Journal of Clinical and Translational Science
IS - 1
M1 - e48
ER -