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Decision support and the effectiveness of web-based delivery and information tailoring for bowel cancer screening : an exploratory study

Flight, Ingrid H., Wilson, Carlene J., Zajac, Ian T., Hart, Elizabeth and McGillivray, Jane A. 2012, Decision support and the effectiveness of web-based delivery and information tailoring for bowel cancer screening : an exploratory study, JMIR research protocols, vol. 1, no. 2, pp. 1-18.

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Title Decision support and the effectiveness of web-based delivery and information tailoring for bowel cancer screening : an exploratory study
Author(s) Flight, Ingrid H.
Wilson, Carlene J.
Zajac, Ian T.
Hart, Elizabeth
McGillivray, Jane A.
Journal name JMIR research protocols
Volume number 1
Issue number 2
Start page 1
End page 18
Total pages 18
Publisher [JMIR Publications Inc]
Place of publication [Toronto, Canada]
Publication date 2012-09-26
ISSN 1929-0748
Keyword(s) Colorectal cancer
decision support techniques
communication
multimedia
mass screening
Summary Background: Colorectal cancer (CRC) is the third most commonly diagnosed cancer in males and the second in females throughout the developed world. Population screening using fecal occult blood tests (FOBTs) facilitates early detection and greater chance of survival, but participation rates are low. We developed a Web-based decision tool to provide information tailored to an individual’s decision stage for CRC screening and attitude toward screening utilizing the Preventive Health Model (PHM) and Precaution Adoption Process Model (PAPM) as theoretical frameworks for screening behavior. We describe the practical steps employed in the tool’s design and the subsequent conduct of an exploratory study.
Objective: To design a decision tool for CRC screening and conduct an exploratory study among average-risk men and women to (1) test the impact of message type (tailored vs non-tailored) and message delivery modality (Web-based vs paper-based) on attitudes toward screening and screening uptake, and (2) investigate the acceptability of the decision tool and relevance of materials.
Methods: Participants (n = 100), recruited from a population sample of men and women aged 50-76 residing in urban Adelaide, Australia, were randomly assigned to a control group or one of 4 interventions: (1) Web-based and tailored information, (2) paper-based and tailored information, (3) Web-based and non-tailored (generic) information, or (4) paper-based and non-tailored information. Participation was augmented by snowball recruitment (n = 19). Questionnaires based on PHM variables were administered pre- and post-intervention. Participants were given the opportunity to request an FOBT. Following the intervention, participants discussed the acceptability of the tool.
Results: Full data were available for 87.4% (104/119) of participants. Post-intervention, perceived susceptibility scores for individuals receiving tailored information increased from mean 10.6 (SD 2.1) to mean 11.8 (SD 2.2). Scores on self-efficacy increased in the tailored group from mean 11.7 (SD 2.0) to mean 12.6 (SD 1.8). There were significant time x modality x message effects for social influence and salience and coherence, reflecting an increase in these scores for tailored Web-based participants only; social influence scores increased from mean 11.7 (SD 2.6) to mean 14.9 (SD 2.3), and salience and coherence scores increased from mean 16.0 (SD 2.2) to mean 17.7 (SD 2.1). There was no greater influence of modality or message type on movement toward a decision to screen or screening uptake, indicating that neither tailored messages nor a Web modality had superior effect. Overall, participants regarded tailored messages positively, but thought that the Web tool lacked “media richness.”
Conclusions: This exploratory study confirms that tailoring on PHM predictors of CRC screening has the potential to positively address attitudes toward screening. However, tailoring on these variables did not result in significantly increased screening uptake. Future research should consider other possible psychosocial influences. Mode of delivery did not affect outcomes, but as a delivery medium, the Web has economic and logistical advantages over paper.
Notes Reproduced with the kind permission of the copyright owner.
Language eng
Field of Research 170106 Health, Clinical and Counselling Psychology
Socio Economic Objective 920401 Behaviour and Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Ingrid H Flight, Carlene J Wilson, Ian T Zajac, Elizabeth Hart, Jane A McGillivray/ Creative Commons.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30048890

Document type: Journal Article
Collections: School of Psychology
Open Access Collection
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.