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

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.

scholarly journals Knowledge and Informed Decision-Making about Population-Based Colorectal Cancer Screening Participation in Groups with Low and Adequate Health Literacy

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
M. L. Essink-Bot ◽  
E. Dekker ◽  
D. R. M. Timmermans ◽  
E. Uiters ◽  
M. P. Fransen
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Health Literacy ◽  
Decisional Conflict ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Crc Screening ◽  
Adequate Health Literacy ◽  
Screening Participation ◽  
Intention To Participate

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.

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

2015 ◽  
Vol 25 (4) ◽  
pp. 575-582 ◽  
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

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

2017 ◽  
Vol 21 (3) ◽  
pp. 636-646 ◽  
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

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

2010 ◽  
Vol 138 (5) ◽  
pp. S-186
Author(s):  
Maaike Denters ◽  
Marije Deutekom ◽  
Marie-Louise Essink-Bot ◽  
Patrick M. Bossuyt ◽  
Paul Fockens ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Decision Making ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Crc Screening ◽  
Low Educated

scholarly journals A referral aid for smoking cessation interventions in primary care: study protocol for a randomized controlled trial

2021 ◽  
Vol 22 ◽  
Author(s):  
Daniëlle N. Zijlstra ◽  
Jean W.M. Muris ◽  
Catherine Bolman ◽  
J. Mathis Elling ◽  
Vera E.R.A. Knapen ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Structural Equation ◽  
Controlled Trial ◽  
Linear Regression Analysis ◽  
Informed Decision ◽  
Equation Modeling ◽  
Informed Decision Making

Abstract Background: To expedite the use of evidence-based smoking cessation interventions (EBSCIs) in primary care and to thereby increase the number of successful quit attempts, a referral aid was developed. This aid aims to optimize the referral to and use of EBSCIs in primary care and to increase adherence to Dutch guidelines for smoking cessation. Methods: Practice nurses (PNs) will be randomly allocated to an experimental condition or control condition, and will then recruit smoking patients who show a willingness to quit smoking within six months. PNs allocated to the experimental condition will provide smoking cessation guidance in accordance with the referral aid. Patients from both conditions will receive questionnaires at baseline and after six months. Cessation effectiveness will be tested via multilevel logistic regression analyses. Multiple imputations as well as intention to treat analysis will be performed. Intervention appreciation and level of informed decision-making will be compared using analysis of (co)variance. Predictors for appreciation and informed decision-making will be assessed using multiple linear regression analysis and/or structural equation modeling. Finally, a cost-effectiveness study will be conducted. Discussion: This paper describes the study design for the development and evaluation of an information and decision tool to support PNs in their guidance of smoking patients and their referral to EBSCIs. The study aims to provide insight into the (cost) effectiveness of an intervention aimed at expediting the use of EBSCIs in primary care.

scholarly journals Mobile Audio Recording Technology to Promote Informed Decision Making in Advanced Prostate Cancer

2021 ◽  
Author(s):  
Daniel H. Kwon ◽  
Sneha Karthikeyan ◽  
Alison Chang ◽  
Hala T. Borno ◽  
Vadim S. Koshkin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Treatment Decision ◽  
Decisional Conflict ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Castration Resistant Prostate Cancer ◽  
Software Application ◽  
Castration Resistant ◽  
Patient Reported

PURPOSE Men with metastatic castration-resistant prostate cancer increasingly encounter complex treatment decisions. Consultation audio recordings and summaries promote patient informed decision making but are underutilized. Mobile recording software applications may increase access. Little is known regarding the feasibility of implementation in clinical encounters. METHODS We conducted a mixed-methods pilot study in men with progressive metastatic castration-resistant prostate cancer. We instructed patients to use a mobile software application to record an oncology visit. Patients could share the recording with our patient scribing program to receive a written summary. We assessed feasibility and acceptability with postvisit surveys. We measured patient-reported helpfulness of the intervention in decision making and change in Decisional Conflict Scale–informed subscale. We conducted semistructured interviews to explore implementation and analyzed transcripts using thematic analysis. RESULTS Across 20 patients, 18 (90%) recorded their visits. Thirteen of 18 (72%) listened to the recording, and 14 of 18 (78%) received a summary. Eighteen of 20 (90%) visits were telehealth. Fourteen patients (70% of all 20; 78% of 18 question respondents) found the application easy to use. Nine patients (50% of 18 recording patients; 90% of 10 question respondents) reported that the recording helped treatment decision making. Decisional conflict decreased from baseline to 1-week postvisit (47.4-28.5, P < .001). Interviews revealed benefits, facilitators, contextual factors, and technology and patient-related barriers to recordings and summaries. CONCLUSION In this single-institution academic setting, a mobile application for patients to record consultations was a feasible, acceptable, and potentially valued intervention that improved decision making in the telehealth setting. Studies in larger, diverse populations are needed.

scholarly journals A Consent Support Resource with Benefits and Harms of Vaccination Does Not Increase Hesitancy in Parents—An Acceptability Study

Vaccines ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 500
Author(s):  
Ciara McDonald ◽  
Julie Leask ◽  
Nina Chad ◽  
Margie Danchin ◽  
Judith Fethney ◽  
...  
Keyword(s):  
Decision Making ◽  
Vaccine Safety ◽  
Decisional Conflict ◽  
Informed Decision ◽  
Childhood Vaccination ◽  
Vaccine Hesitancy ◽  
Informed Decision Making ◽  
Routine Childhood ◽  
Before And After ◽  
Support Resource

It is unclear whether information given about the benefits and risks of routine childhood vaccination during consent may cue parental vaccine hesitancy. Parents were surveyed before and after reading vaccine consent information at a public expo event in Sydney, Australia. We measured vaccine hesitancy with Parent Attitudes about Childhood Vaccine Short Scale (PACV-SS), informed decision-making with Informed Subscale of the Decisional Conflict Scale (DCS-IS), items from Stage of Decision Making, Positive Attitude Assessment, Vaccine Safety and Side Effect Concern, and Vaccine Communication Framework (VCF) tools. Overall, 416 parents showed no change in vaccine hesitancy (mean PACV-SS score pre = 1.97, post = 1.94; diff = −0.02 95% CI −0.10 to 0.15) but were more informed (mean DCS-IS score pre = 29.05, post = 7.41; diff = −21.63 95% CI −24.17 to −18.56), were more positive towards vaccination (pre = 43.8% post = 50.4%; diff = 6.5% 95% CI 3.0% to 10.0%), less concerned about vaccine safety (pre = 28.5%, post = 23.0%, diff = −5.6% 95% CI −2.3% to −8.8%) and side effects (pre = 37.0%, post = 29.0%, diff = −8.0% 95% CI −4.0% to −12.0%) with no change in stage of decision-making or intention to vaccinate. Providing information about the benefits and risks of routine childhood vaccination increases parents’ informed decision-making without increasing vaccine hesitancy.

scholarly journals 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 ◽  
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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