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Randomized Controlled Trial
. 2017 Apr 15;123(8):1401-1408.
doi: 10.1002/cncr.30489. Epub 2016 Dec 21.

An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial

Aubri S Hoffman  1 , Lisa M Lowenstein  1 , Geetanjali R Kamath  1 , Ashley J Housten  1 , Viola B Leal  1 , Suzanne K Linder  2 , Maria L Jibaja-Weiss  3 , Gottumukkala S Raju  4 , Robert J Volk  1
Affiliations
Randomized Controlled Trial

An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial

Aubri S Hoffman et al. Cancer. .

Abstract

Background: Colorectal cancer screening rates for African American patients remain suboptimal. Patient decision aids designed with an entertainment-education approach have been shown to improve saliency and foster informed decision making. The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior.

Methods: Eighty-nine participants were randomized to view 1) a patient decision aid video containing culturally tailored information about colorectal cancer screening options and theory-based support in decision making presented in an entertainment-education format or 2) an attention control video about hypertension that contained similarly detailed information. Participants met with their clinician and then completed follow-up questionnaires assessing their knowledge, decisional conflict, self-advocacy, attitudes, perceived social norms, and intentions. At 3 months, completion of screening was assessed by chart review.

Results: Viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy. No significant differences were observed in participants' attitudes, norms, or intentions. At three months, 23% of all patients had completed a colonoscopy.

Conclusions: Designing targeted, engaging patient decision aids for groups that receive suboptimal screening holds promise for improving patient decision making and self-advocacy. Additional research is warranted to investigate the effectiveness of such aids in clinical practices with suboptimal screening rates and on downstream behaviors (such as repeat testing). Cancer 2017;123:1401-1408. © 2016 American Cancer Society.

Keywords: African American; choice behaviors; colorectal cancer; decision aids; screening.

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Conflict of interest statement

Potential Competing Interests

The authors declare no conflicts of interest associated with this manuscript.

Figures

Figure 1
Figure 1
Conceptual framework of colorectal cancer (CRC) screening decisions (and selected study outcomes)–
Figure 2
Figure 2
Consolidated Standards of Reporting Trials diagram.
See this image and copyright information in PMC

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