Abstract
The impact of patient–physician communication on subsequent patient behavior has rarely been evaluated in the context of colorectal cancer (CRC) screening discussions. We describe physicians’ use of persuasive techniques when recommending CRC screening and evaluate its association with patients’ subsequent adherence to screening. Audio recordings of N = 414 periodic health examinations were joined with screening use data from electronic medical records and pre-/post-visit patient surveys. The association between persuasion and screening was assessed using generalized estimating equations. According to observer ratings, primary care physicians frequently use persuasive techniques (63 %) when recommending CRC screening, most commonly argument or refutation. However, physician persuasion was not associated with subsequent screening adherence. Physician use of persuasion may be a common vehicle for information provision during CRC screening discussions; however, our results do not support the sole reliance on persuasive techniques if the goal is to improve adherence to recommended screening.
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Acknowledgements
This research was supported by a grant from the National Institutes of Health (NIH R01 CA112379). The funder had no role in the study design, conduct, or analyses, or in the reporting of findings.
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None of the authors report having a conflict of interest.
Statement of adherence to ethical standards
All study procedures were conducted in accordance with established ethical standards, and all participants provided informed consent prior to study inclusion. The Institutional Review Boards at Henry Ford Medical Group, Case Western Reserve University and Virginia Commonwealth University approved all aspects of the research.
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NIH R01 CA112379
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Implications
Practice: Physician use of persuasion to increase CRC screening uptake is not sufficient when used in isolation.
Research: Future investigations of the impact of persuasion when used in combination with other communication techniques and of various facets of persuasion, such as the quality of the persuasive communication, are needed to better understand how persuasion may be used to improve CRC screening use.
Policy: Although communication skills training among primary care practitioners has the potential to enhance CRC screening, such training needs to look beyond the use of persuasive communication techniques.
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Lafata, J.E., Wunderlich, T., Flocke, S.A. et al. Physician use of persuasion and colorectal cancer screening. Behav. Med. Pract. Policy Res. 5, 87–93 (2015). https://doi.org/10.1007/s13142-014-0284-x
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DOI: https://doi.org/10.1007/s13142-014-0284-x