S1130 To Ascertain Informed Decision-Making in Colorectal Cancer (CRC) Screening, More Emphasis Should Be Placed on Low Educated Invitees

Objective. To analyze and compare decision-relevant knowledge, decisional conflict, and informed decision-making about colorectal cancer (CRC) screening participation between potential screening participants with low and adequate health literacy (HL), defined as the skills to access, understand, and apply information to make informed decisions about health.Methods. Survey including 71 individuals with low HL and 70 with adequate HL, all eligible for the Dutch organized CRC screening program. Knowledge, attitude, intention to participate, and decisional conflict were assessed after reading the standard information materials. HL was assessed using the Short Assessment of Health Literacy in Dutch. Informed decision-making was analyzed by the multidimensional measure of informed choice.Results. 64% of the study population had adequate knowledge of CRC and CRC screening (low HL 43/71 (61%), adequate HL 47/70 (67%),p>0.05). 57% were informed decision-makers (low HL 34/71 (55%), adequate HL 39/70 (58%),p>0.05). Intention to participate was 89% (low HL 63/71 (89%), adequate HL 63/70 (90%)). Respondents with low HL experienced significantly more decisional conflict (25.8 versus 16.1;p=0.00).Conclusion. Informed decision-making about CRC screening participation was suboptimal among both individuals with low HL and individuals with adequate HL. Further research is required to develop and implement effective strategies to convey decision-relevant knowledge about CRC screening to all screening invitees.

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The Role of Health Literacy in Explaining the Relation between Educational Level and Decision Making about Colorectal Cancer Screening

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234644 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4644

Author(s):

Anke J. Woudstra ◽

Ellen M. A. Smets ◽

Mathilde G. E. Verdam ◽

Mirjam P. Fransen

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Structural Equation ◽

Decisional Conflict ◽

Informed Decision ◽

Informed Decision Making ◽

Descriptive Norm ◽

Injunctive Norm ◽

Crc Screening

Little is known about why educational inequalities exist in informed decision making in colorectal cancer (CRC) screening. Insight into the role and impact of health literacy is essential for intervention development. This study investigates associations between health literacy and informed decision making in CRC screening and explores to what extent health literacy mediates the association between education and informed decision making in CRC screening. In total, 696 individuals eligible for CRC screening (55–75 years of age) were recruited from online panels and filled in an online questionnaire at T0 (n = 696), T1 (n = 407) and T2 (n = 327). A hypothetical mediation model was tested using structural equation modelling. Outcomes included CRC knowledge, CRC screening knowledge, attitude, injunctive norm, descriptive norm, risk perception, self-efficacy, decisional conflict and decisional certainty. Health literacy domains included Comprehension, Application, Numeracy and Communication. Comprehension, Application and Numeracy, were found to mediate the association between education and knowledge about CRC and CRC screening, injunctive norm, descriptive norm, decisional conflict and decisional certainty. In light of these findings, targeting multiple health literacy domains in decision-support interventions is essential for facilitating informed decision making in CRC screening.

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Health literacy and informed decision making regarding colorectal cancer screening: a systematic review

European Journal of Public Health ◽

10.1093/eurpub/ckv005 ◽

2015 ◽

Vol 25 (4) ◽

pp. 575-582 ◽

Cited By ~ 31

Author(s):

Iris van der Heide ◽

Ellen Uiters ◽

A. Jantine Schuit ◽

Jany Rademakers ◽

Mirjam Fransen

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Decision Making ◽

Health Literacy ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Informed Decision ◽

Informed Decision Making

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Health literacy skills for informed decision making in colorectal cancer screening: Perceptions of screening invitees and experts

Health Expectations ◽

10.1111/hex.12658 ◽

2017 ◽

Vol 21 (3) ◽

pp. 636-646 ◽

Cited By ~ 6

Author(s):

Anke J. Woudstra ◽

Daniëlle R. M. Timmermans ◽

Ellen Uiters ◽

Evelien Dekker ◽

Ellen M. A. Smets ◽

...

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

Health Literacy ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Literacy Skills ◽

Informed Decision ◽

Informed Decision Making

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An RCT of a decision aid to support informed choices about taking aspirin to prevent colorectal cancer and other chronic diseases: a study protocol for the SITA (Should I Take Aspirin?) trial

Trials ◽

10.1186/s13063-021-05365-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Shakira Milton ◽

Jennifer McIntosh ◽

Finlay Macrae ◽

Patty Chondros ◽

Lyndal Trevena ◽

...

Keyword(s):

Colorectal Cancer ◽

Decision Making ◽

General Practice ◽

Chronic Diseases ◽

Decision Aid ◽

Low Dose ◽

Informed Decision ◽

Informed Decision Making ◽

Dose Aspirin ◽

Low Dose Aspirin

Abstract Background Australian guidelines recommend that all people aged 50–70 years old actively consider taking daily low-dose aspirin (100–300 mg per day) for 2.5 to 5 years to reduce their risk of colorectal cancer (CRC). Despite the change of national CRC prevention guidelines, there has been no active implementation of the guidelines into clinical practice. We aim to test the efficacy of a health consultation and decision aid, using a novel expected frequency tree (EFT) to present the benefits and harms of low dose aspirin prior to a general practice consultation with patients aged 50–70 years, on informed decision-making and uptake of aspirin. Methods Approximately five to seven general practices in Victoria, Australia, will be recruited to participate. Patients 50–70 years old, attending an appointment with their general practitioner (GP) for any reason, will be invited to participate in the trial. Two hundred fifty-eight eligible participants will be randomly allocated 1:1 to intervention or active control arms using a computer-generated allocation sequence stratified by general practice, sex, and mode of trial delivery (face-to-face or teletrial). There are two co-primary outcomes: informed decision-making at 1-month post randomisation, measured by the Multi-dimensional Measure of Informed Choice (MMIC), and self-reported daily use of aspirin at 6 months. Secondary outcomes include decisional conflict at 1-month and other behavioural changes to reduce CRC risk at both time points. Discussion This trial will test the efficacy of novel methods for implementing national guidelines to support informed decision-making about taking aspirin in 50–70-year-olds to reduce the risk of CRC and other chronic diseases. Trial registration The Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001003965. Registered on 10 October 2020.

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