An effective educational strategy for improving knowledge, risk perception, and risk communication among colorectal adenoma patients.
BACKGROUND
We have previously shown that most adenoma patients are unaware of the personal and familial implications of their diagnosis. Our goal was to determine whether a brief, computer-based educational program (CBEP) administered alone after polypectomy, or in combination with a personalized letter (PL), was more effective than standard care (SC) for heightening awareness and improving risk communication.


METHODS
Using a quasi-randomized design, adenoma-bearing subjects were assigned to the CBEP +PL (n=99), CBEP (n=96), or SC (n=120) arms. The CBEP was administered before discharge from the endoscopy unit. All subjects completed a phone survey 3 months postpolypectomy assessing knowledge, risk perception, and notification of first-degree relatives.


RESULTS
Composite knowledge scores were higher (P<0.05) for the CBEP+PL group than CBEP and SC groups. Subjects in the CBEP+PL group were more likely (P<0.05) than those in the SC group to know that adenomas but not hyperplastic polyps were precancerous, that patients with adenomas were at increased risk of future adenomas, and that the siblings and children of adenoma patients may be at increased colorectal cancer risk. Subjects in the CBEP+PL group were also more likely (P<0.05) to know their polyp's histology, perceive themselves and their siblings/children to be at increased risk of colorectal neoplasia, and notify a first-degree relative. These associations remained significant after adjusting for age, sex, race/ethnicity, education, and endoscopist. No differences were observed between the CBEP and SC groups.


CONCLUSIONS
The CBEP+PL intervention is an effective strategy for improving knowledge, risk perception, and risk communication among adenoma patients.
Department of Medicine, Boston University School of Medicine, Boston, MA, USA. paul.schroy@bmc.org
Paul C
PC
Schroy
Julie T
JT
Glick
Sheila
S
Wilson
Patricia A
PA
Robinson
Timothy C
TC
Heeren
D018256:Adenomatous Polyps / Q000523:psychology* / Q000601:surgery; D003111:Colonic Polyps / Q000601:surgery; D015179:Colorectal Neoplasms / Q000523:psychology* / Q000601:surgery; D003142:Communication; D003194:Computer-Assisted Instruction / Q000379:methods; D003625:Data Collection; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010465:Perception; D012307:Risk Factors