Designing an effective CRC screening education intervention with touchscreen kiosks

Latinos have a colorectal cancer screening gap in excess of 20-points below the 70.5 benchmark for colorectal cancer screening in Healthy People 2020. CDC data for 2008 indicate that 46.5% of Latino men and 51.0% of Latinas reported recommended colorectal cancer screening. Notably, the screening rates were substantially lower for Latinos at the lower end of the socioeconomic scale, which puts them at higher risk for late-stage cancer diagnoses and lower chances of survival. Regular colorectal cancer screening is the key to improving Latino colorectal cancer survival, yet screening promotion interventions must overcome significant and persistent cultural and linguistic barriers. This cancer education intervention was designed to educate and motivate Latinos to get screened for colorectal cancer. The intervention content was explicitly designed to overcome knowledge, attitudinal, linguistic, cultural and attention barriers. The intervention was delivered though interactive, multimedia touchscreen kiosks featuring culturally and linguistically appropriate colorectal cancer information designed for low-income, low literacy Latinos. The interactive touch-sensitive capabilities of the kiosks permitted delivery of information tailored to the person's language preference, age and gender. The intervention made extensive use of video segments and animation to convey complex information in clear and compelling fashion. A randomized control efficacy study found that the intervention significantly improved screening behavior. It suggests that the intervention content resonated well with low-income Latinos and motivated the majority of them, 53%, to obtain colorectal cancer screening; indeed an effect size of this magnitude indicates that this intervention was remarkably effective at overcoming cultural and cognitive barriers.