Interactive, Culturally Sensitive Education on Colorectal Cancer Screening

Background: Increasing colorectal cancer screening (CRCS) can have a substantial positive impact on morbidity and mortality. Objectives: The purpose of this report is to describe the development and feasibility testing of a computer-based, theory-guided educational program designed to increase CRCS. Research Design: This mixed-methods study used focus groups and subsequent randomized controlled trial design. Subjects: Participants (N = 199) were randomized to an intervention or control group; 75% were African American; mean age was 57.36 (SD = 6.8); 71% were male. Measures: Previously validated measures on knowledge, beliefs, and screening test adherence were used to establish pre-and postintervention perceptions. Feasibility was measured by response and completion rates, and participants' perceptions of the program. Results: Before feasibility testing, the program was presented to 2 focus groups. Changes were made to the program based on discussion, leading to a visually appealing, easy to understand and navigate, self-paced program. In the RCT pilot test that followed, of the participants in the intervention group, 80% said the education helped them decide to get CRCS; 49% agreed it helped them overcome barriers; 91% agreed it was useful, 68% thought it raised new concerns about cancer, but only 30% said it made them worry about CRC; 95% agreed their doctor's office should continue giving such education, and 99% said they would inform family about the program. Conclusions: The response rate of 83% demonstrated feasibility of conducting colorectal cancer education in the primary care setting; overall the program was well received; participants averaged 23 minutes to complete it. Participants sought no help from attending data collectors and navigated the revised touch screen program with ease. Computer-based education is feasible in primary care clinics.