The impact of illustrations on public understanding of the aim of cancer screening.
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.
Brotherstone
Hannah
H
Health Behaviour Unit, Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK.
Miles
Anne
A
Robb
Kathryn A
KA
Atkin
Wendy
W
Wardle
Jane
J
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