Department of Public Health Programmes, Randers Regional Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
Department of Public Health Programmes, Randers Regional Hospital, Denmark; Division of Population Medicine, School of Medicine, Cardiff University, UK.
Patient Educ Couns. 2020 Feb;103(2):359-368. doi: 10.1016/j.pec.2019.08.029. Epub 2019 Aug 19.
This trial tested the effectiveness of a self-administered web-based decision aid, targeted at citizens with lower educational attainment, on informed choice about colorectal cancer screening participation as assessed by group levels of knowledge, attitudes and uptake.
The randomised controlled trial was conducted among 2702 screening-naïve Danish citizens, 53-74 years old, with lower educational attainment. Baseline questionnaire respondents (62%) were allocated to intervention and control groups. Intervention group citizens received the decision aid. Outcomes were informed choice, worries and decisional conflict.
Analyses were conducted among 339 eligible citizens. The mean difference in knowledge score change between intervention and control group was 0.00 (95% confidence interval (CI): -0.38;0.38). Trends towards more positive screening attitudes (mean difference in score change: 0.72, 95% CI: -0.38;1.81) and higher screening uptake (7.6%, 95% CI:-2.2;17.4%) were observed. Worries (-0.33, 95% CI: -0.97;0.32) and decisional conflict (mean difference: -3.5, 95%CI: -7.0;-0.1) were slightly reduced.
The decision aid did not affect informed choice or knowledge. However, there were trends towards increased screening uptake and more positive screening attitudes.
Being a simple intervention and easily administered, the decision aid could represent a cost-effective way of enhancing screening uptake, and some elements of informed decision-making.
本试验旨在检验一种自我管理的基于网络的决策辅助工具对受教育程度较低的公民在接受结直肠癌筛查方面的知情选择的有效性，其评估指标为知识、态度和参与率的群体水平。
该随机对照试验在 2702 名无筛查经验的丹麦受教育程度较低的 53-74 岁公民中进行。基线问卷的应答者（62%）被分配到干预组和对照组。干预组公民接受决策辅助工具。结局指标为知情选择、担忧和决策冲突。
对 339 名符合条件的公民进行了分析。干预组和对照组之间知识评分变化的平均差异为 0.00（95%置信区间（CI）：-0.38；0.38）。筛查态度呈积极变化的趋势（评分变化的平均差异：0.72，95% CI：-0.38；1.81），筛查参与率升高（7.6%，95% CI：-2.2%；17.4%）。担忧减少（-0.33，95% CI：-0.97；0.32），决策冲突（平均差异：-3.5，95%CI：-7.0；-0.1）也略有降低。
决策辅助工具并未影响知情选择或知识。然而，筛查参与率增加和筛查态度更积极的趋势是存在的。
作为一种简单的干预措施，易于实施，该决策辅助工具可能是提高筛查参与率和某些知情决策要素的一种具有成本效益的方法。
