Amsterdam UMC, University of Amsterdam, Department of Public Health, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands.
Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, the Netherlands.
Patient Educ Couns. 2019 Oct;102(10):1847-1858. doi: 10.1016/j.pec.2019.04.029. Epub 2019 Apr 30.
Making an informed decision about colorectal cancer screening requires health literacy. Our aim was to develop and pilot-test a computer-based decision aid to support informed decision making about whether or not to participate in colorectal cancer screening for individuals with varying health literacy levels in the Netherlands.
First, we designed and adapted the decision aid prototype among 25 individuals with low (n = 15) and adequate (n = 10) health literacy. Second, we used a before/after study to assess changes in knowledge, attitude, intention, decisional conflict, deliberation, anxiety and risk perception in an online survey among 81 individuals eligible for colorectal cancer screening with low (n = 35) and adequate (n = 46) health literacy.
The decision aid was acceptable, comprehensible, reduced decisional conflict, increased deliberation and improved knowledge about colorectal cancer screening, but not about colorectal cancer, among individuals with adequate and low health literacy. Usability was slightly higher for participants with adequate health literacy compared to those with low health literacy.
The decision aid is promising in supporting informed decision making about colorectal cancer screening, also among individuals with lower health literacy.
Further refinement of interactive features, such as videos, animations and the values clarification exercise, is needed to increase the usability of the decision aid.
做出有关结直肠癌筛查的明智决策需要具备健康素养。我们的目的是开发并试点测试一种基于计算机的决策辅助工具，以支持不同健康素养水平的个体在荷兰是否参与结直肠癌筛查做出知情决策。
首先，我们在 25 名低健康素养（n=15）和足够健康素养（n=10）个体中设计并改编了决策辅助工具原型。其次，我们使用前后研究在一项在线调查中评估了 81 名有结直肠癌筛查资格的个体（低健康素养 n=35，足够健康素养 n=46）中知识、态度、意向、决策冲突、思考、焦虑和风险感知的变化。
该决策辅助工具在具有足够和低健康素养的个体中是可以接受的、可理解的，它降低了决策冲突，增加了思考，并提高了对结直肠癌筛查的了解，但对结直肠癌的了解没有提高。与低健康素养的参与者相比，具有足够健康素养的参与者对可用性的评价略高。
该决策辅助工具在支持具有不同健康素养的个体做出有关结直肠癌筛查的知情决策方面具有很大的潜力。
需要进一步改进交互功能，如视频、动画和价值观澄清练习，以提高决策辅助工具的可用性。
