Table 2 Intervention components
| Â | Motivational interviewing | Patient navigation |
|---|---|---|
Initial Session (in person when possible) | Review lifestyle recommendations in the NHLBI Pamphlets. | Review information in American Cancer Society and Prevent Cancer Foundation DVD/pamphlets: |
• Weight loss for those with a BMI >25 | • Colorectal cancer and statistics relevant to black men | |
• At least 180 min/week of physical activity | • Risk factors, symptoms and healthy behaviors | |
• No more than 1500 mg/day of dietary sodium | • CRC screening options | |
• 9-12 daily servings of fruits and vegetables | Explore participant’s barriers (ie lack of knowledge, beliefs and attitudes, fear, logistics) and commitment to CRC screening. | |
• 2-3 servings of low fat dairy product | ||
• Intake of total fat/saturated fat of < 25% and 75% of total calories respectively | Plan follow-up sessions, colonoscopy referral and/or FIT mailing. | |
• Smoking cessation | ||
• Medication adherence | ||
Barriers to the adoption of TLC are explored and initial goal set. | ||
Follow-Up/Maintenance Phase (via phone, 30 minutes per session) | 1) Assess participant’s motivation and confidence in engaging in given lifestyle behavior | Utilize CEEP (Clarify-Empathize-Explain-Plan) counseling during weekly sessions to assist participants in: |
2) Elicit barriers and concerns about adoption of each lifestyle modification | • Overcoming barriers to CRC screening | |
3) Summarize in a non-threatening manner the ‘pros’ and ‘cons’ of participant’s concerns, thereby eliciting positive self-motivational statements about the behavior | • Obtaining colonoscopy referrals or FIT card | |
4) Provide a menu of options to the participant based on the nature of barriers elicited from him | • Scheduling and attending appointments | |
5) Assess participant’s values and goals, in order to help him link his current health behavior pattern to his core values and life goals | • Purchasing bowel preparation prescription | |
6) Global summary of what was discussed and clarification of an agreed upon action plan | • Completing bowel preparation or FIT testing steps | |
• Securing appointment escort | ||
• Troubleshooting insurance issues | ||
• Understanding CRC screening results | ||
• Completing treatment follow-up for positive results |