SingHealth Polyclinics, 167, Jalan Bukit Merah, Connection One, Tower 5, #15-10, Singapore, 150167, Singapore.
Ministry of Health Holdings, Singapore, Singapore.
BMC Med Inform Decis Mak. 2021 Mar 6;21(1):86. doi: 10.1186/s12911-021-01404-1.
Colorectal cancer (CRC) is a common malignancy worldwide. Despite being the most common cancer in Singapore, CRC screening rate remains low due to knowledge deficits, social reasons such as inconvenience and a lack of reminder or recommendation. A decision aid (DA) may facilitate an individual's decision-making to undertake CRC screening by addressing misconceptions and barriers. We postulate that a more person-centred and culturally adapted DA will better serve the local population. The views of the target users are thus needed to develop such a DA. A CRC screening DA prototype has been adapted from an American DA to cater to the Asian users. This study aimed to explore user perspectives on an adapted CRC screening DA-prototype in terms of the design, content and perceived utility.
The study used in-depth interviews (IDIs) and focus group discussions (FGDs) to gather qualitative data from English-literate multi-ethnic Asian adults aged 50 years old and above. They had yet to screen for CRC before they were recruited from a public primary care clinic in Singapore. The interviews were audio-recorded, transcribed and analysed to identify emergent themes via thematic analysis.
This study included 27 participants involved in 5 IDI and 5 FGDs. Participants found the DA easily comprehensible and of appropriate length. They appreciated information about the options and proposed having multi-lingual DAs. The design, in terms of the layout, size and font, was well-accepted but there were suggestions to digitalize the DA. Participants felt that the visuals were useful but there were concerns about modesty due to the realism of the illustration. They would use the DA for information-sharing with their family and for discussion with their doctor for decision making. They preferred the doctor's recommendation for CRC screening and initiating the use of the DA.
Participants generally had favourable perceptions of the DA-prototype. A revised DA will be developed based on their feedback. Further input from doctors on the revised DA will be obtained before assessing its effectiveness to increase CRC screening rate in a randomized controlled trial.
结直肠癌（CRC）是一种常见的恶性肿瘤，在全球范围内都很常见。尽管结直肠癌是新加坡最常见的癌症，但由于知识缺乏、社会原因（如不便和缺乏提醒或建议），CRC 筛查率仍然很低。决策辅助（DA）可以通过解决误解和障碍来帮助个人做出进行 CRC 筛查的决策。我们推测，一个更以个人为中心和文化适应的 DA 将更好地为当地居民服务。因此，需要目标用户的意见来开发这样的 DA。一个 CRC 筛查 DA 原型已经从美国的 DA 改编而来，以迎合亚洲用户。本研究旨在探讨目标用户对改编后的 CRC 筛查 DA 原型在设计、内容和感知效用方面的看法。
该研究使用深入访谈（IDIs）和焦点小组讨论（FGDs）从新加坡一家公立初级保健诊所招募的尚未进行 CRC 筛查的 50 岁及以上的英语熟练的多种族亚洲成年人那里收集定性数据。访谈进行了录音、转录和分析，通过主题分析识别出主题。
本研究包括 27 名参与者，他们参与了 5 次 IDI 和 5 次 FGD。参与者发现 DA 易于理解且篇幅适当。他们赞赏有关选项的信息，并提出制作多语言 DA。设计方面，布局、大小和字体都得到了很好的接受，但也有人建议将 DA 数字化。参与者认为视觉效果很有用，但由于插图的逼真性，他们对隐私问题表示担忧。他们将使用 DA 与家人分享信息，并与医生讨论做出决策。他们更喜欢医生推荐进行 CRC 筛查并启动 DA 的使用。
参与者对 DA 原型总体上有较好的看法。将根据他们的反馈意见对 DA 进行修订。在进行随机对照试验评估其有效性以提高 CRC 筛查率之前，将从医生那里获得对修订后的 DA 的进一步意见。
