{"id":{"repo_id":"wfu","oai_identifier":"oai:wakespace.lib.wfu.edu:10339/14765"},"canonical_url":"https://search.dev.ndltd.org/etd/wfu/oai:wakespace.lib.wfu.edu:10339/14765","repository":{"repo_id":"wfu","name":"Wake Forest University","base_url":"https://wakespace.lib.wfu.edu/oai/request"},"display":{"title":"Overcoming Literacy Barriers in Colorectal Cancer Screening: a Randomized Trial of a Web-based Decision Aid","abstract":"Background: Patients with low health literacy have difficulty understanding health information and receive fewer preventive services. We sought to determine whether a literacy-sensitive, web-based decision aid (DA) could increase colorectal cancer (CRC) screening rates in both low and high literacy patients. Methods: Patients at a community-based health center who were overdue for CRC screening were randomized to view either the web-based CRC screening DA or a control program about medication safety. All patients completed a baseline and post-program survey. Blinded chart review determined screening test ordering and completion rates. Results: Of the 248 patients who completed the study, 54% had limited health literacy. Compared to the control patients, DA patients were more likely to report a testing preference (84% vs. 53%, p<0.0001) and an increase in readiness to receive screening (29% vs. 10%, p<0.001). More DA patients had CRC screening tests ordered (31% vs. 23%) and completed (19% vs. 14%), but the differences were not statistically significant (multivariate p=0.08 and 0.07 respectively). Similar results were found when stratifying by literacy level. Conclusions: The DA increased patients’ test preferences and intent to receive screening. Future studies should investigate how to link the DA with other supportive strategies to increase screening rates.","abstract_html":"Background: Patients with low health literacy have difficulty understanding health information and receive fewer preventive services. We sought to determine whether a literacy-sensitive, web-based decision aid (DA) could increase colorectal cancer (CRC) screening rates in both low and high literacy patients. Methods: Patients at a community-based health center who were overdue for CRC screening were randomized to view either the web-based CRC screening DA or a control program about medication safety. All patients completed a baseline and post-program survey. Blinded chart review determined screening test ordering and completion rates. Results: Of the 248 patients who completed the study, 54% had limited health literacy. Compared to the control patients, DA patients were more likely to report a testing preference (84% vs. 53%, p&lt;0.0001) and an increase in readiness to receive screening (29% vs. 10%, p&lt;0.001). More DA patients had CRC screening tests ordered (31% vs. 23%) and completed (19% vs. 14%), but the differences were not statistically significant (multivariate p=0.08 and 0.07 respectively). Similar results were found when stratifying by literacy level. Conclusions: The DA increased patients’ test preferences and intent to receive screening. Future studies should investigate how to link the DA with other supportive strategies to increase screening rates.","abstract_has_math":false,"creators":["Miller, David Jr"],"institution":"Wake Forest University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2009,"date_issued":"2009-12-29T13:56:13Z","date_published":"2009-12-29T13:56:13Z","updated_at":"2026-07-27T22:01:01Z","subjects":["computer assisted instruction"],"languages":["en_US"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/10339/14765","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Miller, David Jr"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2009-12-29T13:56:13Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2009-12-29T13:56:13Z"]},{"key":"dc:date.issued","label":"Date","values":["2009-12-29T13:56:13Z"]},{"key":"dc:publisher","label":"Institution","values":["Wake Forest University"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["computer assisted instruction"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en_US"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/10339/14765"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Patients with low health literacy have difficulty understanding health information and receive fewer preventive services. We sought to determine whether a literacy-sensitive, web-based decision aid (DA) could increase colorectal cancer (CRC) screening rates in both low and high literacy patients. Methods: Patients at a community-based health center who were overdue for CRC screening were randomized to view either the web-based CRC screening DA or a control program about medication safety. All patients completed a baseline and post-program survey. Blinded chart review determined screening test ordering and completion rates. Results: Of the 248 patients who completed the study, 54% had limited health literacy. Compared to the control patients, DA patients were more likely to report a testing preference (84% vs. 53%, p<0.0001) and an increase in readiness to receive screening (29% vs. 10%, p<0.001). More DA patients had CRC screening tests ordered (31% vs. 23%) and completed (19% vs. 14%), but the differences were not statistically significant (multivariate p=0.08 and 0.07 respectively). Similar results were found when stratifying by literacy level. Conclusions: The DA increased patients’ test preferences and intent to receive screening. Future studies should investigate how to link the DA with other supportive strategies to increase screening rates."]},{"key":"dc:title","label":"Title","values":["Overcoming Literacy Barriers in Colorectal Cancer Screening: a Randomized Trial of a Web-based Decision Aid"]}]}],"canonical_facts":{"dc:creator":["Miller, David Jr"],"dc:date.accessioned":["2009-12-29T13:56:13Z"],"dc:date.available":["2009-12-29T13:56:13Z"],"dc:date.issued":["2009-12-29T13:56:13Z"],"dc:description.abstract":["Background: Patients with low health literacy have difficulty understanding health information and receive fewer preventive services. We sought to determine whether a literacy-sensitive, web-based decision aid (DA) could increase colorectal cancer (CRC) screening rates in both low and high literacy patients. Methods: Patients at a community-based health center who were overdue for CRC screening were randomized to view either the web-based CRC screening DA or a control program about medication safety. All patients completed a baseline and post-program survey. Blinded chart review determined screening test ordering and completion rates. Results: Of the 248 patients who completed the study, 54% had limited health literacy. Compared to the control patients, DA patients were more likely to report a testing preference (84% vs. 53%, p<0.0001) and an increase in readiness to receive screening (29% vs. 10%, p<0.001). More DA patients had CRC screening tests ordered (31% vs. 23%) and completed (19% vs. 14%), but the differences were not statistically significant (multivariate p=0.08 and 0.07 respectively). Similar results were found when stratifying by literacy level. Conclusions: The DA increased patients’ test preferences and intent to receive screening. Future studies should investigate how to link the DA with other supportive strategies to increase screening rates."],"dc:identifier.uri":["http://hdl.handle.net/10339/14765"],"dc:language.iso":["en_US"],"dc:publisher":["Wake Forest University"],"dc:subject":["computer assisted instruction"],"dc:title":["Overcoming Literacy Barriers in Colorectal Cancer Screening: a Randomized Trial of a Web-based Decision Aid"],"dc:type":["Thesis"]},"updated_at":"2026-07-27T22:01:01Z"}