Development and pilot-testing of a colorectal cancer screening decision aid for individuals with varying health literacy levels

PATIENT EDUCATION AND COUNSELING

卷:102

Article

Woudstra, Anke J.¹  Smets, Ellen M. A.²  Dekker, Evelien³  Broens, Tom H. F.⁴  Penning, Judith¹  Smith, Sian⁵  McCaffery, Kirsten^6,7  Fransen, Mirjam P.¹ 

[1] Univ Amsterdam, Amsterdam UMC, Dept Publ Hlth, Amsterdam Publ Hlth Res Inst, Meibergdreef 9, Amsterdam, Netherlands

[2] Univ Amsterdam, Amsterdam UMC, Dept Med Psychol, Amsterdam Publ Hlth Res Inst, Meibergdreef 9, Amsterdam, Netherlands

[3] Univ Amsterdam, Amsterdam UMC, Dept Gastroenterol & Hepatol, Meibergdreef 9, Amsterdam, Netherlands

[4] Univ Amsterdam, Amsterdam UMC, Dept Med Informat, Meibergdreef 9, Amsterdam, Netherlands

[5] UNSW Sydney, Psychosocial Res Grp, Prince Wales Clin Sch, Fac Med,Lowy Res Ctr, Sydney, NSW, Australia

[6] Univ Sydney, Wiser Healthcare, Sydney Sch Publ Hlth, Sydney, NSW 2006, Australia

[7] Univ Sydney, Sydney Hlth Literacy Lab, Sydney Sch Publ Hlth, Sydney, NSW 2006, Australia

关键词: Decision aid;    Colorectal cancer screening;    Health literacy;    Informed decision making;    Computer-based;   

DOI  :  10.1016/j.pec.2019.04.029

来源: Elsevier

【 摘 要 】

Objective: Making an informed decision about colorectal cancer screening requires health literacy. Our aim was to develop and pilot-test a computer-based decision aid to support informed decision making about whether or not to participate in colorectal cancer screening for individuals with varying health literacy levels in the Netherlands. Methods: First, we designed and adapted the decision aid prototype among 25 individuals with low (n = 15) and adequate (n = 10) health literacy. Second, we used a before/after study to assess changes in knowledge, attitude, intention, decisional conflict, deliberation, anxiety and risk perception in an online survey among 81 individuals eligible for colorectal cancer screening with low (n = 35) and adequate (n = 46) health literacy. Results: The decision aid was acceptable, comprehensible, reduced decisional conflict, increased deliberation and improved knowledge about colorectal cancer screening, but not about colorectal cancer, among individuals with adequate and low health literacy. Usability was slightly higher for participants with adequate health literacy compared to those with low health literacy. Conclusion: The decision aid is promising in supporting informed decision making about colorectal cancer screening, also among individuals with lower health literacy. Practice implications: Further refinement of interactive features, such as videos, animations and the values clarification exercise, is needed to increase the usability of the decision aid. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

Free