title: Developing a computer touch-screen interactive colorectal screening decision aid for a low-literacy African American population: lessons learned.
abstract: African Americans have higher colorectal cancer (CRC) mortality than White Americans and yet have lower rates of CRC screening. Increased screening aids in early detection and higher survival rates. Coupled with low literacy rates, the burden of CRC morbidity and mortality is exacerbated in this population, making it important to develop culturally and literacy appropriate aids to help low-literacy African Americans make informed decisions about CRC screening. This article outlines the development of a low-literacy computer touch-screen colonoscopy decision aid using an innovative marketing method called perceptual mapping and message vector modeling. This method was used to mathematically model key messages for the decision aid, which were then used to modify an existing CRC screening tutorial with different messages. The final tutorial was delivered through computer touch-screen technology to increase access and ease of use for participants. Testing showed users were not only more comfortable with the touch-screen technology but were also significantly more willing to have a colonoscopy compared with a "usual care group." Results confirm the importance of including participants in planning and that the use of these innovative mapping and message design methods can lead to significant CRC screening attitude change.
authors.affiliation: Department of Public Health, Temple University, Philadelphia, PA 19122, USA. sbass@temple.edu
authors.forename: Sarah Bauerle
authors.initials: SB
authors.lastname: Bass
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Gordon
authors.forename: Sheryl Burt
authors.initials: SB
authors.lastname: Ruzek
authors.forename: Caitlin
authors.initials: C
authors.lastname: Wolak
authors.forename: Dominique
authors.initials: D
authors.lastname: Ruggieri
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mora
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rovito
authors.forename: Johnson
authors.initials: J
authors.lastname: Britto
authors.forename: Lalitha
authors.initials: L
authors.lastname: Parameswaran
authors.forename: Zainab
authors.initials: Z
authors.lastname: Abedin
authors.forename: Stephanie
authors.initials: S
authors.lastname: Ward
authors.forename: Anuradha
authors.initials: A
authors.lastname: Paranjape
authors.forename: Karen
authors.initials: K
authors.lastname: Lin
authors.forename: Brian
authors.initials: B
authors.lastname: Meyer
authors.forename: Khaliah
authors.initials: K
authors.lastname: Pitts
mesh_terms: D001741:Black or African American; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology; D003201:Computers; D003661:Decision Support Techniques; D055088:Early Detection of Cancer / Q000379:methods*; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D014584:User-Computer Interface
keywords: colonoscopy; colorectal cancer (CRC); computer touch-screen; perceptual mapping; screening