Essink-Bot M L, Dekker E, Timmermans D R M, Uiters E, Fransen M P
Department of Public Health, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, Netherlands.
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, Netherlands.
Gastroenterol Res Pract. 2016;2016:7292369. doi: 10.1155/2016/7292369. Epub 2016 Apr 20.
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.
目的。分析和比较健康素养（HL）较低和充足的潜在结直肠癌（CRC）筛查参与者之间与决策相关的知识、决策冲突以及关于CRC筛查参与的知情决策情况。健康素养定义为获取、理解和应用信息以做出关于健康的知情决策的技能。方法。对71名健康素养较低者和70名健康素养充足者进行调查，他们均符合荷兰有组织的CRC筛查计划的条件。在阅读标准信息材料后，评估知识、态度、参与意愿和决策冲突。使用荷兰语健康素养简短评估工具评估健康素养。通过知情选择的多维测量方法分析知情决策情况。结果。64%的研究人群对CRC和CRC筛查有足够的了解（健康素养较低者43/71（61%），健康素养充足者47/70（67%），p>0.05）。57%的人是知情决策者（健康素养较低者34/71（55%），健康素养充足者39/70（58%），p>0.05）。参与意愿为89%（健康素养较低者63/71（89%），健康素养充足者63/70（90%））。健康素养较低的受访者经历的决策冲突明显更多（25.8对16.1；p = 0.00）。结论。在健康素养较低者和健康素养充足者中，关于CRC筛查参与的知情决策都不理想。需要进一步研究来制定和实施有效的策略，将与CRC筛查决策相关的知识传达给所有筛查受邀者。
