title: Using a computer to teach patients about fecal occult blood screening. A randomized trial.
abstract: OBJECTIVE
  To determine whether a multimedia computer program could effectively teach patients about fecal occult blood testing (FOBT) and increase screening rates.
  
  
  METHODS
  Randomized trial.
  
  
  METHODS
  University-affiliated, community-based Internal Medicine outpatient practice.
  
  
  METHODS
  All English-speaking patients aged 50 years and older who were offered FOBT screening by their providers were invited to participate. Two hundred and four patients enrolled in the study. Ten patients were later determined to be ineligible.
  
  
  METHODS
  Patients were randomized to either the educational multimedia computer program or usual nurse counseling about FOBT screening. Screening instructions were based on the material pre-printed on each test kit. Educational sessions were held in a private setting immediately after each patient's office visit.
  
  
  RESULTS
  A knowledge-assessment questionnaire was administered in a blinded fashion by telephone the following day. Successful screening was defined as return of the test kits within 30 d. Completion of the FOBT kits was similar in both groups: 62% (58/93) in the computer group and 63% (64/101) in the nurse group (P=.89). Mean knowledge scores were also similar, but there was a trend toward increased knowledge mastery in the computer group (56% vs 41%, P=.09).
  
  
  CONCLUSIONS
  A multimedia educational computer program was as effective as usual nurse counseling in educating patients and achieving adherence to FOBT screening. Future studies are needed to determine whether computer-assisted instruction can improve health outcomes.
authors.affiliation: Department of Internal Medicine, Section of General Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1051, USA. dmiller@wfubmc.edu
authors.forename: David P
authors.initials: DP
authors.lastname: Miller
authors.forename: James R
authors.initials: JR
authors.lastname: Kimberly
authors.forename: L Douglas
authors.initials: LD
authors.lastname: Case
authors.forename: James L
authors.initials: JL
authors.lastname: Wofford
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003194:Computer-Assisted Instruction; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D019212:Multimedia; D015999:Multivariate Analysis; D009780:Occult Blood; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods*