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Gregory P Samsa

Publications and source records attributed to Gregory P Samsa.

At least 19 recordsLinked to original sources
PubMed2006

Quality measures for the use of adjuvant chemotherapy and radiation therapy in patients with colorectal cancer: a systematic review.

BACKGROUND: Chemotherapy (CT) and radiation therapy (RT) are essential components of adjuvant (preoperative or postoperative) therapy for many patients with colorectal cancer (CRC); however, quality measures (QMs) of these critical aspects of CRC treatment have not been characterized well. Therefore, the authors conducted a systematic review of the literature to determine the available QMs for adjuvant CT and RT in patients with CRC and rated their usefulness for assessing the delivery of quality care. METHODS: The MEDLINE and Cochrane data bases were searched for all publications that contained potential/actual QMs pertaining to adjuvant therapy for CRC. Identified QMs were rated by using criteria developed by the National Quality Forum. RESULTS: Thirty-two articles met the established inclusion/exclusion criteria. Those 32 articles contained 12 potential or actual QMs, 6 of which had major flaws that limited their applicability. The most useful QMs identified were 1) the percentage of patients with AJCC Stage III colon cancer who received postoperative CT and 2) the percentage of patients with Stage II or III rectal cancer who received chemoradiotherapy. CONCLUSIONS: To the authors' knowledge, very few QMs pertaining to adjuvant CT or RT for CRC have been published to date, and only half of those measures were rated as useful, acceptable, and valid in the current literature review. Future research should focus on refining existing QMs and on developing new QMs that target important leverage points with respect to the provision of adjuvant therapy for patients with CRC.

Chemotherapy, Adjuvant↗
PubMed2006

Response of high-sensitivity C-reactive protein to exercise training in an at-risk population.

BACKGROUND: High-sensitivity C-reactive protein (hsCRP) is promoted as an independent predictor of atherosclerotic risk. In addition, cardiorespiratory fitness is inversely related to hsCRP in single-sex cross-sectional analyses. Our objective was to determine if modulating fitness with exercise training imposes changes in high-sensitivity C-reactive protein in a mixed-sex population at risk for cardiovascular disease. METHODS: We studied baseline and postintervention plasma hsCRP in 193 sedentary, overweight to mildly obese, dyslipidemic men and women who were randomized to 6 months of inactivity or 1 of 3 aerobic exercise groups: low amount-moderate intensity (energy equivalent of approximately 19.3 km/wk at 40%-55% peak VO2), low amount-high intensity (energy equivalent of approximately 19.3 km/wk at 65%-80% peak VO2), or high amount-high intensity (energy equivalent of approximately 32.2 km/wk at 65%-80% peak VO2). RESULTS: At baseline, the study population was at intermediate to high cardiovascular risk as defined by hsCRP. Cardiorespiratory fitness was inversely related to hsCRP (P < .001) even after adjusting for significant and expected sex differences. Fitness, hormone replacement therapy use, and high-density lipoprotein cholesterol accounted for the sex difference in baseline hsCRP. Fitness, high-density lipoprotein cholesterol, fasting insulin, hormone replacement therapy, and visceral adiposity were all independent predictors for baseline hsCRP (r2 = 0.34 for the entire model, P < .0001). However, despite significant improvements in fitness, visceral adiposity, subcutaneous adiposity, and insulin sensitivity, hsCRP did not change in response to exercise training (P > .20). CONCLUSIONS: Cardiorespiratory fitness is inversely related to hsCRP independent of sex and accounts for most of the large sex disparity in hsCRP. Nonetheless, in the absence of a significant change in diet, 6 months of aerobic exercise training does not produce a significant change in hsCRP in an at-risk population.

Adult↗
PubMed2006

Assessing weight-related quality of life in adolescents.

OBJECTIVE: The development of a new weight-related measure to assess quality of life in adolescents [Impact of Weight on Quality of Life (IWQOL)-Kids] is described. RESEARCH METHODS AND PROCEDURES: Using a literature search, clinical experience, and consultation with pediatric clinicians, 73 items were developed, pilot tested, and administered to 642 participants, 11 to 19 years old, recruited from weight loss programs/studies and community samples (mean z-BMI, 1.5; range, -1.2 to 3.4; mean age, 14.0; 60% female; 56% white). Participants completed the 73 items and the Pediatric Quality of Life Inventory and were weighed and measured. RESULTS: Four factors (27 items) were identified (physical comfort, body esteem, social life, and family relations), accounting for 71% of the variance. The IWQOL-Kids demonstrated excellent psychometric properties. Internal consistency coefficients ranged from 0.88 to 0.95 for scales and equaled 0.96 for total score. Convergent validity was demonstrated with strong correlations between IWQOL-Kids total score and the Pediatric Quality of Life Inventory (r = 0.76, p < 0.0001). Significant differences were found across BMI groups and between clinical and community samples, supporting the sensitivity of this measure. Participants in a weight loss camp demonstrated improved IWQOL-Kids scores, suggesting responsiveness of the IWQOL-Kids to weight loss/social support intervention. DISCUSSION: The present study provides preliminary evidence regarding the psychometric properties of the IWQOL-Kids, a weight-related quality of life measure for adolescents. Given the rise of obesity in youth, the development of a reliable and valid weight-related measure of quality of life is timely.

Adolescent↗
PubMed2006

Facilitated process improvement: an approach to the seamless linkage between evidence and practice in CKD.

BACKGROUND: Two common strategies for guideline implementation are preformed practice improvement tools, such as flowcharts, and process reengineering by total quality management (TQM) teams. Prespecified tools fail to accommodate local circumstances, TQM requires an unrealistic level of local commitment, and neither has a proven track record for success. METHODS: We describe an alternative approach termed facilitated process improvement (FPI), a systematic exploration of potential modifications to systems of care, and its application to the implementation of an evidence-based chronic kidney disease (CKD) guideline, focusing on individuals not yet requiring renal replacement therapy. The FPI steps followed by the implementation work group to develop a set of implementation tools for the Renal Physicians Association Advanced CKD Guideline included: (1) developing functional specifications of processes, including actions and prerequisites required; (2) investigating processes of care in a variety of site types to understand processes and reasons for failures; (3) developing practical tools corresponding to root causes of failures of processes and subprocesses; and (4) developing a meta-tool to tailor local selection of tools. RESULTS: Formal needs assessment identified processes of care related to 3 major tasks: identify patients, develop and communicate patient-specific management plan, and implement plan. Subtasks were identified to address root causes of failures, and, for each, tools were modified from existing or developed de novo by the work group, which further developed an organized management approach that uses 4 categories of tools: (1) assessment tools identify opportunities for improvements; (2) tailoring tools, a unique feature of this approach, determine which tools are applicable; (3) implementation tools identify patients and communicate and implement management plan; and (4) evaluation tools assess the impact of implementation. CONCLUSION: The work group, in collaboration with community clinicians, patients, and CKD and tool experts, developed and used FPI to provide a range of tools in a fashion that supports and simplifies local assessment, tailoring, implementation, and evaluation. With the formative work completed, practitioners whose practice improvement experience level and other resources may be limited will find it more feasible and practical to provide optimal advanced CKD management without the demands of conventional TQM or continuous quality improvement.

Chronic Disease↗
PubMed2006

Changing physician knowledge, attitudes, and beliefs about migraine: evaluation of a new educational intervention.

OBJECTIVE: Use a presurvey of primary care providers (PCPs) enrolled in a continuing medical education (CME) program on headache management to ascertain their existing knowledge, attitudes, and beliefs regarding migraine and use a postsurvey to determine the extent to which the CME program has brought participant knowledge, attitudes, and skills closer to conformance with best evidence. BACKGROUND: Migraine is a common and debilitating condition, which PCPs may not always manage satisfactorily. In an effort to improve management, the American Headache Society has developed a CME program called BRAINSTORM that encourages PCPs to adopt the US Headache Consortium Guidelines for headache care. METHODS: A 20-item questionnaire was developed that covered the essential elements of migraine care. The questionnaire was administered before and after a BRAINSTORM presentation to 254 consenting primary care clinicians attending a medical meeting at 1 of 6 sites. A control group of 112 comparable physicians who did not attend the presentation completed the same questionnaire. Prepresentation scores of attendees were compared to scores of nonattendees to assess the generalizability of results. Prepresentation scores on selected questions were used to assess participant baseline knowledge, attitudes, and beliefs. Pre- and postpresentation scores for attendees at all sites were compared using the Mantel-Haenszel statistic to assess the effectiveness of the BRAINSTORM CME. Pre- and postpresentation scores were compared by site using the Breslow-Day test to evaluate any differential impact based on CME location. RESULTS: Prepresentation scores of attendees and nonattendees were found to be similar. No significant difference in performance was noted across sites. A chi-square analysis revealed a statistically significant difference between pre- and postpresentation scores for 16 of the test's 20 questions. In the pretest, all participants scored <66% on 2 questions related to prevalence, impact, and pathophysiology of migraine, 2 questions pertaining to history taking/physical examination, and 3 migraine management questions. Attendee scores improved to >66% posttest on all except 2 questions related to prevalence, impact, and pathophysiology of migraine. CONCLUSION: Our results indicate that PCPs need to acquire greater understanding about the epidemiology and pathophysiology of migraine and may require guidance in history taking and physical examination of migraine patients. Improvement in scores posttest confirms that the BRAINSTORM program has a significant immediate impact on the knowledge, beliefs, and attitudes of participants. The program could be strengthened to improve emphasis in some areas where posttest scores showed no improvement.

Attitude of Health Personnel↗
PubMed2005

Comparative efficacy of hand hygiene agents in the reduction of bacteria and viruses.

BACKGROUND: Health care-associated infections most commonly result from person-to-person transmission via the hands of health care workers. METHODS: We studied the efficacy of hand hygiene agents (n = 14) following 10-second applications to reduce the level of challenge organisms (Serratia marcescens and MS2 bacteriophage) from the hands of healthy volunteers using the ASTM-E-1174-94 test method. RESULTS: The highest log 10 reductions of S marcescens were achieved with agents containing chlorhexidine gluconate (CHG), triclosan, benzethonium chloride, and the controls, tap water alone and nonantimicrobial soap and water (episode 1 of hand hygiene, 1.60-2.01; episode 10, 1.60-3.63). Handwipes but not alcohol-based handrubs were significantly inferior from these agents after a single episode of hand hygiene, but both groups were significantly inferior after 10 episodes. After a single episode of hand hygiene, alcohol/silver iodide, CHG, triclosan, and benzethonium chloride were similar to the controls in reduction of MS2, but, in general, handwipes and alcohol-based handrubs showed significantly lower efficacy. After 10 episodes, only benzethonium chloride (1.33) performed as well as the controls (1.59-1.89) in the reduction of MS2. CONCLUSIONS: Antimicrobial handwashing agents were the most efficacious in bacterial removal, whereas waterless agents showed variable efficacy. Alcohol-based handrubs compared with other products demonstrated better efficacy after a single episode of hand hygiene than after 10 episodes. Effective hand hygiene for high levels of viral contamination with a nonenveloped virus was best achieved by physical removal with a nonantimicrobial soap or tap water alone.

Adult↗
PubMed2005

Increasing colorectal cancer screening among individuals in the carpentry trade: test of risk communication interventions.

BACKGROUND: Individuals in the carpentry trade, due to lifestyle habits and occupational exposures, may be at above-average risk for colorectal cancer (CRC). Based on the literature which suggests that increasing perceived risk motivates behavior change, we report on the effectiveness of four risk-communication interventions targeted to increase initial, yearly and repeat fecal occult screening (FOBT) among carpenters (N = 860) over a 3-year period. METHODS: Our 2 x 2 factorial design intervention study varied two dimensions of providing CRC risk factor information: (1) type of risk factor-one set of interventions emphasized three basic risk factors (age, family history and polyps); the other set emphasized a comprehensive set of risk factors including basic, lifestyle, and occupational factors, and (2) tailoring/not tailoring risk factor information. Participants were provided FOBTs. Outcomes were the proportion of returned FOBTs. RESULTS: Varying the amount and intensity of delivering CRC risk factors information affected neither risk perceptions nor initial, yearly, or repeat screening. However, yearly and repeat screening rates were greater among participants who received interventions addressing comprehensive set of risk factors, especially with increasing age. CONCLUSIONS: Tailoring on several CRC risk factors appears insufficient to increase and sustain elevated perceptions of CRC risks to promote screening.

Age Factors↗
PubMed2005

Burden of illness and satisfaction with care among patients with headache seen in a primary care setting.

OBJECTIVE: To assess the current level of headache burden and the headache management needs at three diverse clinical sites. BACKGROUND: Headache is a common disabling disorder that is costly for the patient and a management challenge for physicians. The determination of whether and how to intervene to improve headache management depends on both the burden of disease and the characteristics of patients that would likely be targeted. METHODS: Patients from three healthcare organizations were identified by administrative records as having either migraine or tension-type headache and then mailed a survey that addressed demographics, headache type, headache-related disability, depression and anxiety, satisfaction with care, general health, worry about headache, problems with headache management, and healthcare utilization. Comparisons were made across sites and between patients with more and less severe headache-related impairments. RESULTS: Of the 789 patients contacted, 385 (50%) returned a survey. While the socio-demographic characteristics of the patients were diverse, headache-related characteristics were similar. These patients have significant problems with headache management, disability, pain, worry, and dissatisfaction with care. Patients who described higher headache-related impairment experienced significantly greater problems in these areas, perceived themselves to be in worse general health, and had significantly greater use of medical services than those with lower headache severity. CONCLUSIONS: Despite various elements of heterogeneity, we observed across the sites a consistent need for improvement in headache management. Future efforts should be directed at developing and evaluating methods for effectively improving headache management.

Adult↗
PubMed2005

Point-of-care testing of the international normalized ratio in patients with antiphospholipid antibodies.

Antiphospholipid antibodies can influence the results of clotting tests in a subset of patients, which can be a major obstacle in monitoring warfarin. The aim was to determine if point-of-care testing of the International Normalized Ratio (INR) is influenced by antiphospholipid antibodies. We compared 59 patients receiving warfarin for a diagnosis of antiphospholipid antibody syndrome (APS) to 49 patients receiving warfarin for atrial fibrillation to evaluate the consistency between INR results obtained by different methods. INR results obtained by finger stick (capillary whole-blood) and venipuncture (non-citrated and citrated whole-blood) were compared with our laboratory plasma-based prothrombin time assay. Five patients (8%) with APS and both elevated anti-beta2glycoprotein I levels and positive lupus anticoagulants had non-measurable ProTime INR results and generally higher Hemochron Signature INR results than the plasma-based method, but the corresponding chromogenic factor X results were not supratherapeutic. For the remaining patients, differences between the plasma-based INR and the point-of-care INR results ranged from 0.2 +/- 0.2 to 0.4 +/- 0.3. The differences were similar for patients with APS and atrial fibrillation for all INR comparisons with the exception of the plasma-based method compared with the ProTime, which showed a mean absolute difference of 0.4 +/- 0.3 for APS patients and of 0.2 +/- 0.2 for atrial fibrillation patients (p = 0.02). In a subset ofAPS patients, the ProTime system will not yield an INR result and the HEMochron Signature (citrate and non-citrate whole-blood) INR results will exhibit elevated INR results. For this subset of APS patients, we suggest using an alternative method to monitor warfarin.

Adult↗
PubMed2005

A cost-minimization analysis comparing azithromycin-based and levofloxacin-based protocols for the treatment of patients hospitalized with community-acquired pneumonia: results from the CAP-IN trial.

BACKGROUND: A randomized trial was performed comparing azithromycin and levofloxacin for treating moderately to severely ill patients hospitalized with community-acquired pneumonia. This is a cost-minimization analysis comparing those regimens. METHODS: The cost-minimization analysis compares 81 patients receiving sequential therapy with IV azithromycin plus IV ceftriaxone followed by oral azithromycin with 82 patients receiving IV levofloxacin followed by oral levofloxacin, all with complete economic data over approximately 30 days, including information about hospitalization, study medications, home care, postdischarge utilization, and lost productivity. Units of utilization were multiplied by unit prices in order to estimate cost per patient. These total costs were compared using a two-sample t test. RESULTS: Direct medical costs of the azithromycin group were 2,481 US dollars less than the corresponding costs in the levofloxacin group (p = 0.03; 95% confidence interval, 238 US dollars to 4,724 US dollars). Most of the cost difference (2,300 US dollars) is attributable to hospital days, with the majority of these days being spent on the general medicine wards. The precise magnitude of the cost advantage attributable to azithromycin, if any, depends on both the reduction in length of hospital stay and its associated daily cost. CONCLUSIONS: Azithromycin was no more costly than levofloxacin, and perhaps less so. Cost is but one of many factors that should be considered by clinicians in decisions involving any individual patient.

Aged↗
PubMed2004

Charlson Index comorbidity adjustment for ischemic stroke outcome studies.

BACKGROUND AND PURPOSE: The Charlson Index is commonly used in outcome studies to adjust for patient comorbid conditions, but has not been specifically validated for use in studies of ischemic stroke. The purpose of the present study was to determine whether outcomes of ischemic stroke patients varied on the basis of the Charlson Index. METHODS: The Department of Veterans Affairs (VA) Stroke Study prospectively identified stroke patients admitted to 9 VA hospitals between April 1995 and March 1997. The Charlson Index was scored on the basis of discharge International Classification of Diseases, 9th Revision, Clinical Modification coding and dichotomized (low comorbidity 0 or 1 versus high > or =2) for analysis. Validity was assessed on the basis of modified Rankin score at hospital discharge (good outcome 0 or 1 versus poor > or =2 or dead) and 1-year mortality, adjusting for initial stroke severity. RESULTS: Of the 960 enrolled ischemic stroke patients, 23% had a Charlson Index of 0, 34% 1, 22% 2, 12% 3, and 8% > or =4. Forty-eight percent of those with a low Charlson Index had a good outcome at discharge versus 37% of those with a high Charlson Index (P<0.001). For 1-year mortality, the proportions were 16% versus 26%, respectively (P<0.001). Logistic regression adjusting for initial stroke severity showed that those with a high Charlson Index had 36% increased odds of having a poor outcome at discharge (P=0.038) and 72% greater odds of death at 1 year (P=0.001). Every 1-point increase in Charlson Index was independently associated with a 15% increase in the odds of a poor outcome at discharge (P<0.005) and a 29% increase in the odds of death by 1 year (P<0.001). CONCLUSIONS: These data support the validity of the Charlson Index as a measure of comorbidity for use in ischemic stroke outcome studies.

Aged↗
PubMed2004

Alzheimer disease: operating characteristics of PET--a meta-analysis.

PURPOSE: To assess the operating characteristics of positron emission tomography (PET) by using fluorine 18 fluorodeoxyglucose (FDG) in the diagnosis of Alzheimer disease. MATERIALS AND METHODS: Articles published between 1989 and 2003 were identified in the MEDLINE, CINAHL, and HealthSTAR databases. Articles were selected if FDG PET was performed with a dedicated scanner and the resolution was specified, if standard criteria were used for the diagnosis of Alzheimer disease, if at least 12 human subjects with Alzheimer disease were enrolled in the study, if clinical diagnosis or histopathologic findings were used as the reference standard, and if sufficient data were provided to construct a 2 x 2 table. Two reviewers independently abstracted data regarding the operating characteristics (sensitivity and specificity) of PET and evaluated the study quality. A meta-analysis was performed by constructing a summary receiver operating characteristic curve and by combining the sensitivity and specificity values by using a random-effects model. RESULTS: Fifteen articles that met the inclusion criteria showed heterogeneity in sensitivity and specificity estimates that were not related to quality features with no plausible explanations. The summary sensitivity of PET was 86% (95% CI: 76%, 93%), and the summary specificity was 86% (95% CI: 72%, 93%). CONCLUSION: The specificity and sensitivity of FDG PET are limited by both study design and patient characteristics. Therefore, the clinical value of these parameters is uncertain; future research on the use of PET in the diagnosis of Alzheimer disease needs to focus on current limitations to be of practical relevance in clinical settings.

Alzheimer Disease↗
PubMed2004

Effects of the amount of exercise on body weight, body composition, and measures of central obesity: STRRIDE--a randomized controlled study.

BACKGROUND: Obesity is a major health problem due, in part, to physical inactivity. The amount of activity needed to prevent weight gain is unknown. OBJECTIVE: To determine the effects of different amounts and intensities of exercise training. DESIGN: Randomized controlled trial (February 1999-July 2002). SETTING AND PARTICIPANTS: Sedentary, overweight men and women (aged 40-65 years) with mild to moderate dyslipidemia were recruited from Durham, NC, and surrounding communities. INTERVENTIONS: Eight-month exercise program with 3 groups: (1) high amount/vigorous intensity (calorically equivalent to approximately 20 miles [32.0 km] of jogging per week at 65%-80% peak oxygen consumption); (2) low amount/vigorous intensity (equivalent to approximately 12 miles [19.2 km] of jogging per week at 65%-80%), and (3) low amount/moderate intensity (equivalent to approximately 12 miles [19.2 km] of walking per week at 40%-55%). Subjects were counseled not to change their diet and were encouraged to maintain body weight. MAIN OUTCOME MEASURES: Body weight, body composition (via skinfolds), and waist circumference. RESULTS: Of 302 subjects screened, 182 met criteria and were randomized and 120 completed the study. There was a significant (P<.05) dose-response relationship between amount of exercise and amount of weight loss and fat mass loss. The high-amount/vigorous-intensity group lost significantly more body mass (in mean [SD] kilograms) and fat mass (in mean [SD] kilograms) (-2.9 [2.8] and -4.8 [3.0], respectively) than the low-amount/moderate-intensity group (-0.9 [1.8] and -2.0 [2.6], respectively), the low-amount/vigorous-intensity group (-0.6 [2.0] and -2.5 [3.4], respectively), and the controls (+1.0 [2.1] and +0.4 [3.0], respectively). Both low-amount groups had significantly greater improvements than controls but were not different from each other. Compared with controls, all exercise groups significantly decreased abdominal, minimal waist, and hip circumference measurements. There were no significant changes in dietary intake for any group. CONCLUSIONS: In nondieting, overweight subjects, the controls gained weight, both low-amount exercise groups lost weight and fat, and the high-amount group lost more of each in a dose-response manner. These findings strongly suggest that, absent changes in diet, a higher amount of activity is necessary for weight maintenance and that the positive caloric imbalance observed in the overweight controls is small and can be reversed by a modest amount of exercise. Most individuals can accomplish this by walking 30 minutes every day.

Adult↗
PubMed2004

Gender and racial differences in lipoprotein subclass distributions: the STRRIDE study.

Recent research has focused on the potential atherogenicity of various lipoprotein subclasses and their link to coronary heart disease (CHD) risk. This investigation seeks to identify differences in lipoprotein subclass distributions among a biracial, middle-aged population, while controlling for a number of confounding risk factors. Fasting plasma samples were analyzed in 285 sedentary, mildly dyslipidemic, overweight individuals between 40 and 65 years with no known history of CHD or diabetes. Women had lower levels of small and medium LDL, medium VLDL, large VLDL, and small HDL with a much higher concentration of large HDL than men. Whites had significantly more IDL, small LDL, medium VLDL, and large VLDL with lower levels of large LDL than blacks. HDL and LDL size were larger among blacks and women; VLDL size was greater among whites and men. There was also a trend for men to have more LDL particles than women and whites to have a higher LDL particle concentration than blacks. Within this homogenous population, there were distinct differences between gender and racial groups. Blacks and women had less atherogenic profiles than whites and men, which was not evident from the standard lipid panel.

Adult↗
PubMed2004

How strong is the relationship between functional status and quality of life among persons with stroke?

The quantitative relationship between functional status and self-reported quality of life is relatively unexamined. As part of the 1-, 6-, and 12-month telephone follow-up of consecutive patients in an observational study of patients with stroke, we found that while higher functional status was associated with better quality of life, this relationship was relatively weak (Spearman correlation <0.25). Patients with similar levels of disability reported quite different qualities of life. Any improvement in quality of life over time was modest at best. Mean utilities for patients with minor stroke were near 0.80, while those for patients with major stroke were near 0.60, the latter figure exceeding previous reports. Quality of life with major stroke may not necessarily be as low as that reported before such a stroke occurs. Quality of life after stroke is heterogeneous and depends on more than just level of physical function.

Activities of Daily Living↗
PubMed2004

Modifying attributions of colorectal cancer risk.

We report how a four-group risk communication intervention targeted to individuals in the carpentry trade affected their perceived causes (i.e., attributions) for increased colorectal cancer (CRC) risk. The intervention varied the amount of information presented on CRC risk factors and whether participants received tailored feedback on their risk factors. In baseline and 3-month follow-up telephone surveys, carpenters (N = 860) reported their perceived absolute and comparative CRC risks, perceived causes for increased CRC risk, and knowledge of CRC risk factors. At follow-up, neither the type or amount of information provided, nor the use of tailoring, appreciably and consistently affected whether participants mentioned their specific risk factor (e.g., lifestyle, occupational) emphasized in their intervention information. Furthermore, attributions did not affect CRC risk perceptions. These results suggest that participants do not integrate sufficiently CRC risk factor information into their conceptualizations of CRC risk, and that more effective methods are needed to contextualize risk factors information to achieve the goal of modifying CRC risk perceptions.

Aged↗