title: The impact of illustrations on public understanding of the aim of cancer screening.
abstract: OBJECTIVE
  To study the effectiveness of visual illustrations in improving people's understanding of the preventive aim of flexible sigmoidoscopy (FS) screening.
  
  
  METHODS
  Three-hundred and eighteen people aged 60-64 were offered an appointment to attend FS screening and randomly allocated to receive either written information alone or written information plus illustrations. The illustrations showed the adenoma-carcinoma sequence and how it can be interrupted by removing polyps found during FS. Telephone interviews were conducted with a randomly selected sub-set of people prior to their screening appointment to assess their knowledge and understanding of the test (n=65). The interviews were tape-recorded, transcribed and content analysed by researchers blind to the condition people had been allocated to.
  
  
  RESULTS
  In the written information only group, 57% understood that the test was looking for polyps rather than just cancer, whilst in the group who received written information and illustrations, 84% understood this. Logistic regression analyses confirmed that addition of illustrations resulted in significantly better understanding (OR=3.75; CI: 1.16-12.09; p=0.027), and this remained significant controlling for age, gender and Townsend scores (an area-based measure of deprivation) (OR=10.85; CI: 1.72-68.43; p=0.01).
  
  
  CONCLUSIONS
  Illustrations improved understanding of the preventive aim of FS screening.
  
  
  CONCLUSIONS
  Pictoral illustrations could be used to facilitate patient understanding of screening.
authors.affiliation: Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Brotherstone
authors.forename: Anne
authors.initials: A
authors.lastname: Miles
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Robb
authors.forename: Wendy
authors.initials: W
authors.lastname: Atkin
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
mesh_terms: D001296:Audiovisual Aids; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008131:London; D008297:Male; D008403:Mass Screening; D011939:Mental Recall; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D012812:Sigmoidoscopy