A randomised controlled trial of a bowel cancer screening decision aid for adults with low education and literacy

点击翻译按钮获取中文摘要

The Commonwealth has committed funds for a national bowel cancer screening program. This will involve mailing bowel testing kits direct to eligible consumers at their homes. To minimise inequalities in accessing screening and to ensure effectiveness of the program, information and instructions for testing will have to be accessible to participants from low as well as high educational backgrounds. This project will evaluate communication strategies to achieve this. Reliance on written information has rapidly increased within healthcare. In particular, the use of patient decision aids to support and inform health decisions is rapidly increasing. The need to improve information in screening programs has been particularly highlighted and decision aids provide an evidence based approach to achieve this. However, whilst there is level 1 evidence that decision aids improve the decision making process for consumers, research has been carried out almost exclusively among educated participants with high literacy. There is concern that the needs of adults with low education and limited literacy have been ignored. The proposed study is 2 phased. Phase I will test optimal quantitative risk communication formats for adults with low education and literacy. Phase 2 will evaluate a tailored low literacy decision aid for FOBT screening. The trial will test whether the decision aid can increase knowledge of screening, increase involvement in decisions and improve the quality of decision making among adults with low education, and will examine its impact on screening intentions and behaviour. This is a highly significant study. Screening providers need better ways to inform consumers of screening programs that are accessible to a diverse audience and equitable across the target population. This study will have direct implications for use in the national bowel cancer screening program.