Sian K Smith|Lyndal Trevena|Judy M. Simpson|Alexandra Barratt|Don Nutbeam|Kirsten McCaffery
A decision aid to support informed choices about bowel cancer screening among adults with low education: randomised controlled trial
University of Sydney|University of Sydney|University of Sydney|University of Sydney|University of Southampton|University of Sydney
determine whether decision aid designed adults low education literacy support informed choice involvement decisions screening bowel cancerrandomised controlled trialareas new south wales australia identified socioeconomically disadvantaged low education attainment high unemployment unskilled occupations572 adults aged 55 64 low educational attainment eligible bowel cancer screeningpatient decision aid comprising paper based interactive booklet without question prompt list dvd presenting quantitative risk information possible outcomes screening using faecal occult blood testing compared testing control group received standard information developed australian national bowel screening programme materials faecal occult blood test kit posted directly peoples homesinformed choice adequate knowledge consistency attitudes screening behaviour preferences involvement screening decisionsparticipants received decision aid showed higher levels knowledge controls mean score maximum score 12 decision aid group 650 95 confidence interval 615 684 control group 410 385 436 p0001 attitudes towards screening less positive decision aid group 51 participants expressing favourable attitudes compared 65 participants control group 14 difference 95 confidence interval 5 23 p0002 participation rate screening reduced decision aid group completion faecal occult blood testing 59 v 75 control group 16 difference 8 24 p0001 decision aid increased proportion participants made informed choice 12 control group 34 decision aid group 22 difference 15 29 p0001 participants decision aid group decisional conflict screening decision compared controls 51 v 38 p002 groups differ general anxiety worry bowel cancertailored decision support information effective supporting informed choices greater involvement decisions faecal occult blood testing among adults low levels education without increasing anxiety worry developing bowel cancer using decision aid make informed choice may however lead lower uptake screening trial registration clinicaltrialsgov nct00765869 australian new zealand clinical trials registry 12608000011381