A video intervention to improve patient understanding of tumor genomic testing in patients with cancer

Abstract

Introduction: Tumor genomic testing (TGT) is standard-of-care for most patients with advanced/metastatic cancer. Despite established guidelines, patient education prior to TGT is frequently omitted. The purpose of this study was to evaluate the impact of a concise 4 min video for patient education prior to TGT.

Methods: Based on a quality improvement cycle, an animated video was created to be applicable to any cancer type, incorporating culturally diverse images, available in English and Spanish. Patients undergoing standard-of-care TGT were enrolled at a tertiary academic institution and completed survey instruments prior to video viewing (T1) and immediately post-viewing (T2). Instruments included: (1) 10-question objective genomic knowledge; (2) 10-question video message-specific knowledge; (3) 11-question Trust in Provider; (4) attitudes regarding TGT.

Results: A total of 150 participants were enrolled. For the primary objective, there was a significant increase in video message-specific knowledge (median 10 point increase; p < 0.0001) with no significant change in genomic knowledge/understanding (p = 0.89) or trust in physician/provider (p = 0.59). Results for five questions significantly improved, including the likelihood of TGT impact on treatment decision, incidental germline findings, and cost of testing. Improvement in video message-specific knowledge was consistent across demographic groups, including age, income, and education.

Conclusions: A concise, 3-4 min, broadly applicable video incorporating culturally diverse images administered prior to TGT significantly improved video message-specific knowledge across all demographic groups. This resource is publicly available at http://www.tumor-testing.com, with a goal to efficiently educate and empower patients regarding TGT while addressing guidelines within the flow of clinical practice.

Keywords: biomarkers; cancer education; cancer management; genomics.

FIGURE 1

Change in knowledge and trust metrics pre‐ to post‐video. Participants completed survey assessments pre‐video viewing (T1) and post‐video viewing (T2) of the 3–4 min tumor genomic testing educational video intervention. Survey assessments included: 10‐question video message‐specific knowledge with score reported as number correct multiplied by 100 (VMSK; A), 10‐question general genomic knowledge and understanding with score reported as number correct multiplied by 100 (GKU; B), and 11‐question trust in physician/provider (TIPP; C). Paired scores for each participant are presented as dashed lines with mean indicated by thick line, and Wilcoxon signed rank p value in bottom right of each plot. Change in video message‐specific knowledge from T1 to T2 was the primary endpoint of the study.