Improving animated instructional videos for colorectal cancer screening: An application of learner verification and revision

Abstract

Latino adults in the USA have low rates of colorectal cancer (CRC) screening. Fecal immunochemical tests (FITs) can improve screening rates. Promoting FIT completion via text-based reminders could improve CRC screening participation, yet literature on text-based interventions for CRC screening among Latino adults is limited. This study employed a user-centered approach, learner verification and revision (LV&R), to improve instructional animated videos on FIT completion and colonoscopy. We interviewed 24 unique patients from a large urban health center in Los Angeles that were sent the animated videos via text message. Patients were age-eligible for CRC screening and spoke English or Spanish. Telephone interviews explored LV&R constructs like acceptability, comprehension, and cultural relevance of the videos. Interviews were recorded, transcribed, and summarized using rapid content analysis techniques. Interviews revealed positive perceptions of both videos' accessibility, content, and appeal. Participants appreciated the straightforward language and clear instructions provided in the videos, which were found to be culturally and linguistically acceptable across English- and Spanish-speaking groups. Videos were viewed as informative and persuasive, motivating participants to consider CRC screening and to share videos with others. To enhance effectiveness of the videos, participants suggested improvements such as adding language related to screening guidelines, colonoscopy bowel preparation, results communication, and reassuring statements about overcoming any fears related to the procedures. By applying LV&R methodology, we improved instructional videos to promote CRC screening and potentially help close the screening gap among Latino adults. Future research might assess the most effective modes of delivering such videos to patients.

Background: Colorectal cancer (CRC) screening rates are low among Latino adults in the USA. An at-home test called the fecal immunochemical test (FIT) can help increase these rates. Sending concise instructional videos via text message may help close CRC screening gaps.

Methods: The study team created customized videos for a target audience of Latino adults. Researchers interviewed 24 patients from a large health center in Los Angeles who were due for CRC screening, had received a FIT kit, and spoke English or Spanish. The interviews were conducted by phone and focused on the videos' acceptability, clarity, usefulness, and cultural relevance.

Results: The participants reported a positive view of the videos, finding them easy to understand and appealing. The clear instructions and straightforward language were well-received in both English and Spanish. Some suggested adding more details about screening guidelines, bowel preparation, results communication, and reassuring statements about overcoming any fears, while keeping the videos short.

Discussion: The study aimed to create effective video messages promoting CRC screening using a method that includes patient feedback. Future research should explore how these videos impact screening rates among Latino adults.

Clinical trial information: ClinicalTrials.gov. ID: NCT06542835.

Keywords: Latinos; colorectal cancer screening; instructional videos; learner verification and revision; qualitative; text-based interventions.