David P. Miller|John G. Spangler|L. D. Case|David C. Goff|Sonal Singh|Michael Pignone
Effectiveness of a Web-Based Colorectal Cancer Screening Patient Decision Aid
Wake Forest University|Wake Forest University|Wake Forest University|Wake Forest University|Johns Hopkins Medicine|Johns Hopkins University|University of North Carolina at Chapel Hill
colorectal cancer crc screening reduces mortality yet remains underutilized low health literacy may contribute underutilization interfering patients ability understand receive preventive health servicesto determine webbased multimedia crc screening patient decision aid developed mixedliteracy audience could increase crc screeningrct patients aged 5074 years overdue crc screening randomized webbased decision aid control program seen immediately scheduled primary care appointmenta large communitybased universityaffiliated internal medicine practice serving socioeconomically disadvantaged populationpatients completed surveys determine ability state screening test preference readiness receive screening charts abstracted masked observers determine screening tests ordered completedbetween november 2007 september 2008 total 264 patients enrolled study data collection completed 2009 data analysis completed 2010 majority participants mean age578 years female 67 africanamerican 74 annual household incomes 20000 76 limited health literacy 56 compared control participants decisionaid participants crc screening preference 84 vs 55 p00001 increase readiness receive screening 52 vs 20 p00001 decisionaid participants crc screening tests ordered 30 vs 21 completed 19 vs 14 statistically significant differences seen aor16 95 ci097 28 aor17 95 ci088 32 respectively similar results found across literacy levelsthe webbased decision aid increased patients ability form test preference intent receive screening regardless literacy level study examine ways decision aid combined additional system changes increase crc screening