230000 Encouraging low-literacy African Americans to be screened for colorectal cancer: An experimental comparison of "usual care" materials with a customized touch-screen tutorial

Wednesday, November 10, 2010 : 9:00 AM - 9:15 AM

Thomas F. Gordon, PhD , Department of Public Health, Temple University, Philadelphia, PA
Sarah Bauerle Bass, PhD, MPH , Department of Public Health, Temple University, Philadelphia, PA
Sheryl Burt Ruzek, PhD, MPH , Department of Public Health, Temple University, Philadelphia, PA
Stephanie Ward, MD, MPH , General Internal Medicine, Temple University, Philadelphia, PA
Anu Paranjape, MD, MPH , General Internal Medicine, Temple University, Philadelphia, PA
Karen Lin, MD, MPH , General Internal Medicine, Temple University, Philadelphia, PA
Brian Meyer, MD, MPH , General Internal Medicine, Temple University, Philadelphia, PA
Caitlin Wolak, MPH , Department of Public Health, Temple University, Philadelphia, PA
Michael J. Rovito, PhD , Department of Public Health, Temple University, Philadelphia, PA
Johnson Britto, MBBS, MPH , Department of Public Health, Temple University, Philadelphia, PA
Zainab Abedin, MPH , Department of Public Health, Temple University, Philadelphia, PA
Gabriella Mora Rovito, BS, MPH(c) , Department of Public Health, Temple University, Philadelphia, PA
Kate Musliner, MPH(c) , Department of Public Health, Temple University, Philadelphia, PA
Colorectal cancer (CRC) is the third leading cause of cancer death in the United States, disproportionately affecting low-literacy African Americans. Survival rates for CRC are high if caught early through screening techniques such as colonoscopy, but African Americans have low rates of use. This presentation summarizes a Random Controlled Experimental Trial of “usual care” print materials with a computer-based touch screen tutorial designed to educate and encourage low-literacy African Americans to have colonoscopy. The tutorial was developed specifically for low literacy African American patients, emphasizing psycho-social barriers to screening and utilizing “testimonials” from real patients who had undergone colonoscopy. Testing was done in the General Internal Medicine clinic of a major university medical center. Patients over the age of 50 who had low literacy (assessed using the REALM-R) were randomly assigned to either the Usual Care group (n=27) or the Tutorial group (n=33). In comparison to the Usual Care print document, the Touch Screen Tutorial was judged to be superior on its length (p=.009), the amount of information it provided (p=.001), the usefulness of the information (p=.005), its balance (p=.001) and ease of use (p=.000). Users of the tutorial also felt it provided enough information to make a decision about colonoscopy (p=.006) and means on overall attitude about having a colonoscopy (p=.001) and likelihood of having a colonoscopy (p=.002) were significantly higher compared to the usual care group. Results indicate a tailored decision aid developed specifically for low literacy minority patients can be extremely effective in encouraging colonoscopy screening.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Chronic disease management and prevention
Diversity and culture
Public health or related research

Learning Objectives:
1. Identify the key barriers for African American patients to be CRC screened. 2. Compare effectiveness of a customized computer based touch screen tutorial to usual care in encouraging colonoscopy in African American patients.

Keywords: Health Communications, Cancer Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have presented before in similar formats. This is no problem at all.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.