Overcoming Literacy Barriers in Colorectal Cancer Screening: a Randomized Trial of a Web-based Decision Aid

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.

Grantor dc:publisher

Wake Forest University

Year dc:date.issued

2009

Author dc:creator

• Miller, David Jr

• computer assisted instruction

Language dc:language.iso

en_US

Handle dc:identifier.uri

http://hdl.handle.net/10339/14765

OAI identifier oai:identifier

oai:wakespace.lib.wfu.edu:10339/14765