Randomised Controlled Trial of a Literacy Sensitive Decision Aid for Bowel Cancer Screening
Ontology highlight
ABSTRACT:
DISEASE(S): Bowel Cancer,Colorectal Neoplasms,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon),Public Health-other Public Health
PROVIDER: 2062056 | ecrin-mdr-crc |
REPOSITORIES: ECRIN MDR
Similar Datasets
Project description:Intervention group:Education + Decision Aid;Control group:Routine Education + Educational Manual
Primary outcome(s): Informed desicion
Study Design: Parallel
| 2716370 | ecrin-mdr-crc
Project description:This project has been completed and consisted of a randomised trial of six tailored decision aids giving patients evidence-based information about faecal occult blood test screening for bowel cancer. 314 Australians aged between 50-74 years were recruited from five general practices and randomised to received either the tailored decision aid with age-gender and family history specific information and values clarification exercise or a standard government information sheet.
The decision aid significantly increased the proportion of people who were informed participants in the screening program.
| 2015614 | ecrin-mdr-crc
Project description:Physicians face a challenge in promoting colorectal cancer screening (CRCS) in the face of multiple competing demands. A decision aid (DA) that clarifies patient preferences and improves decision quality could aid shared decision making (SDM) and be effective at increasing CRCS rates. However, exactly how such DA improves SDM is not clear. This 4-year R01 study funded by the National Cancer Institute seeks to provide detailed understanding of how an interactive DA affects patient-physician communication and SDM, and ultimately CRCS adherence.
| 2118961 | ecrin-mdr-crc
Project description:Interventions: Use of a decision aid during the consultation by the medical oncologist and provision of the decision aid and audiotape for patient to take home. The decision aid contains information on potential managment decisions, risks and benefits of treatment options, side effects, treatment regimes, survival statistics, pros and cons of choices. The duration of use of the DA in the consultation is not set, it may be used as long as is required. The audiotapes is a recording of the content of the booklet. Participants may listen or read the decision aid as often as they wish and the DA and audiotape are theirs to keep.
Consultation length is as long as required.
Primary outcome(s): Enhanced patient achievement of information and involvement preferences and more active involvement in treatment decision-making following use of the decision aid.[Measured immediately post consultation and 2 weeks post decision.]
Study Design: Purpose: Educational / counselling / training; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy
| 2453185 | ecrin-mdr-crc
Project description:The purpose of this study is to determine whether a multimedia educational computer program can increase colorectal cancer screening rates in low and adequate literacy patients.
| 2046372 | ecrin-mdr-crc
Project description:Studies evaluating decisions aids have used a wide range of outcome measures as well as formats and settings. Most studies have focused on patient decision aids used either within the consultation or delivered pre-consultation, but there are no randomised, controlled studies comparing the two. However, timing and format of the patient decision aid intervention may affect how useful the tool is to the patient. The aim of this project is therefore to deepen our understanding of the patient’s engagement in and preparation for the decision making process in a randomised, controlled trial comparing an electronic pre-consultation and paper-based in-consultation patient decision aid. 274 patients with colorectal and breast cancer are enrolled in the study. Data are collected at both patient and consultant perceived levels as well as an observed level of shared decision making.
| 2750869 | ecrin-mdr-crc
Project description:Background and study aims
Regular colorectal cancer (CRC) screening is recommended for people older than 50 years old because they have a higher risk of developing this disease. However, a significant proportion of this population do not comply with this recommendation. The researchers have developed a web-based decision aid (DA) to help people to make an informed decision about undergoing CRC screening. It includes information about the disease, as well as two screening procedures: fecal occult blood test (FOBT) and colonoscopy (their characteristics, potential benefits and harms). The DA is available on the following link: http://www.pydesalud.com/toma-de-decisiones-en-cancer-colorrectal/. The aim of this study is to find out whether this DA can help people to make informed decisions about CRC screening.
Who can participate?
People between 50-69 years old who have no history of CRC or current symptoms, and who have never had been screened for CRC
What does the study involve?
Participants are randomly allocated to either individually review the DA accompanied by a researcher, or to not review the DA. The main outcome assessed is decisional conflict, that is, participants' uncertainty about undergoing CRC screening or not. The study also assesses their knowledge about CRC and the screening procedures, their intention to be screened, and the importance that they attributed to different characteristics of the screening procedures.
| 2426924 | ecrin-mdr-crc
Project description:Background: Sweden has a long tradition of organized national population-based screening programs. Participation rates differ between programs and regions, are relatively high in some groups, but lower in other. To apply an equity perspective on screening, it is desired that individuals make an informed decision on knowledge rather than ignorance, misconceptions, or fear. Decision Aids (DAs) are set to deliver information about different health care options and to help individuals make visible values connected to the options available. DAs are not meant to guide individuals to choose one option over the another. The advantage of an individual Decision Aid (iDA) is that individuals gain knowledge on cancer and screening entering one webpage with possibility to communicate with health professionals and thereafter make their decision regarding participate. The primary objective is therefore to develop and implement a web-based iDA for individuals invited to cancer screening in Sweden. The secondary objective is to evaluate the implemented web-based iDA.
Methods: This study has an evaluative approach with both a process-, an implementation and an outcome evaluation. Multiple methods will be used including patient reported data, focus group discussions and individual interviews using the think aloud technique. The project is based on the framework from The International Patient Decision Aid Standards (IPDAS) and the proposed model development process for DAs as presented by Coulter et al. Individuals aged 23-74, including women aged (the cervical- and breast- and bowel cancer screening module) and men aged (the bowel cancer screening module), will be included in the developmental process. Efforts will be made to recruit participants with disabilities, who live outside society and who are foreign born.
Discussion: To the best of our knowledge the present study is the first aiming at developing an iDA for usage in Swedish context, The iDA is intended to contribute so that individuals invited to screening base their decision on knowledge and with a clear picture of their values and preferences, rather than ignorance, misconceptions, or fear. Furthermore, the iDA is expected to increase knowledge and raise awareness in general about cancer and cancer screening in society.
| 2746091 | ecrin-mdr-crc
Project description:Interventions: This study aims to test the efficacy of a decision aid, using an expected frequency tree which visually displays statistics and further provides numerical evidence and to present the benefits and harms of low dose aspirin, on informed decision making and uptake of aspirin in general practice.
a) Description of the decision aid: The male and female decision aids are brochures with an accompanying 3-minute video. The video is designed to be talked through with the participants in a consultation with a research assistant and it covers the exact information which is found in the hard copy brochure. The video and brochure formats of the decision aid is designed to communicate the benefits and risks of taking low-dose aspirin, 100 – 300 mg per day, as defined by the Cancer Council Australia, to the participants. Each participant will be given the hard copy of the decision aid to take with them after the consultation with the research assistant. The decision aid also prompts the participants to speak with their general practitioner following their consultation with the research assistant as taking aspirin may or may not be right for them.
Primary outcome(s): The primary outcome is self-reported daily adherence to aspirin as assessed by a 6 month follow up a questionnaire which has been designed specifically for this study.[6 months after enrollment];The second primary outcome is participants ability to make an informed choice as measured by the validated scale called the Multi-dimensional Measure of Informed Choice asks about participants knowledge, attitudes and behaviour which is asked in the 1-month follow up questionnaire. [1-month after enrollment ]
Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Efficacy
| 2471220 | ecrin-mdr-crc
Project description:What’s the purpose of this study? This 4-year study is designed: (1) to teach primary care physicians how to recognize low health literacy patients and effectively counsel them on cancer screening using risk communication and shared decision making and (2) to assess the impact of training on changes in physician communication behavior and changes in low health literacy patients’ cancer screening behaviors. This study proposal is based on the hypothesis that physician training in cancer screening guidelines, health literacy, and communication skills will improve provider-patient interactions during encounters dealing with preventive health maintenance especially cancer screening.
How will the proposed study be implemented? Thirty-two physicians in the New Orleans metropolitan area will be recruited and randomly assigned to one of two groups. The unit of randomization will be the health care organization or clinic. The intervention group will receive training in health literacy, cancer screening, risk communication and shared decision-making. The control group will not receive communication training until the end of the study. Physicians in both groups will undergo three clinic visits with standardized patients (actors trained to portray real patients; mystery shoppers) but they will not be aware that they are conducting visits with actors. The visits will occur at study enrollment and at 6 and 12 months. At the end of each clinic visit, the standardized patients will rate the physicians’ communication skills. Each physician assigned to the intervention group will receive verbal feedback on communication skills from the standardized patients and complete a web-based tutorial. Physicians in the control group will not have access to the web-based tutorial until the end of the study.
For each physician, 10-15 patients with limited health literacy will be recruited to the study. Each patient will rate his/her perceived involvement with care and global satisfaction with care at study enrollment and annually for three years. Age and gender-appropriate referral rates for breast, cervical and colorectal cancer screening and patients’ receipt of such screening will be assessed annually for three years. All study physicians, regardless of group assignment, will receive performance feedback (report cards) on their cancer screening rates among low health literacy patients in their clinic.
| 2107228 | ecrin-mdr-crc