Development and pilot-testing of a colorectal cancer screening decision aid for individuals with varying health literacy levels
Development and pilot-testing of a colorectal cancer screening decision aid for individuals with varying health literacy levels
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DOI：
10.1016/j.pec.2019.04.029
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发表时间：
2019-10-01
影响因子：
3.5
通讯作者：
Fransen, Mirjam P.
中科院分区：
文献类型：
--
作者：
Woudstra, Anke J.;Smets, Ellen M. A.;Fransen, Mirjam P.
目的：对结直肠癌筛查做出明智的决定需要健康素养。我们的目的是开发和试点测试一种基于计算机的决策辅助工具，以支持在荷兰为具有不同健康素养水平的个人做出是否参加结直肠癌筛查的知情决策。方法：首先，我们在25名健康素养低（n = 15）和健康素养高（n = 10）的个体中设计并调整了决策辅助原型。其次，我们在81名健康素养低（n = 35）和充分（n = 46）的有资格接受结直肠癌筛查的个体中进行了一项在线调查，使用了前后研究来评估知识、态度、意图、决策冲突、深思熟虑、焦虑和风险感知的变化。结果：在健康素养较低的个体中，决策辅助是可接受的、可理解的，减少了决策冲突，增加了审议和提高了对结直肠癌筛查的了解，但对结直肠癌没有帮助。与健康素养较低的参与者相比，健康素养充足的参与者的可用性略高。结论：决策辅助在支持结直肠癌筛查的知情决策方面有希望，对于健康素养较低的个体也是如此。实践影响：需要进一步改进交互式功能，如视频、动画和价值澄清练习，以增加决策辅助的可用性。(C) 2019 Elsevier B.V.版权所有
Objective: Making an informed decision about colorectal cancer screening requires health literacy. Our aim was to develop and pilot-test a computer-based decision aid to support informed decision making about whether or not to participate in colorectal cancer screening for individuals with varying health literacy levels in the Netherlands.Methods: First, we designed and adapted the decision aid prototype among 25 individuals with low (n = 15) and adequate (n = 10) health literacy. Second, we used a before/after study to assess changes in knowledge, attitude, intention, decisional conflict, deliberation, anxiety and risk perception in an online survey among 81 individuals eligible for colorectal cancer screening with low (n = 35) and adequate (n = 46) health literacy.Results: The decision aid was acceptable, comprehensible, reduced decisional conflict, increased deliberation and improved knowledge about colorectal cancer screening, but not about colorectal cancer, among individuals with adequate and low health literacy. Usability was slightly higher for participants with adequate health literacy compared to those with low health literacy.Conclusion: The decision aid is promising in supporting informed decision making about colorectal cancer screening, also among individuals with lower health literacy.Practice implications: Further refinement of interactive features, such as videos, animations and the values clarification exercise, is needed to increase the usability of the decision aid. (C) 2019 Elsevier B.V. All rights reserved.