title: The development and testing of a brief ('gist-based') supplementary colorectal cancer screening information leaflet.
abstract: OBJECTIVE
  To design and user-test a 'gist-based' colorectal cancer screening information leaflet, which promotes comprehension of the screening offer.
  
  
  METHODS
  Twenty-eight individuals approaching screening age were recruited from organisations in deprived areas of England. Using a between-subjects design, we tested iterations of a newly-designed gist-based information leaflet. Participants read the leaflet and answered 8 'true' or 'false' comprehension statements. For the leaflet to be considered fit-for-purpose, all statements had to be answered correctly by at least 80% of participants in each round. Alterations were made if this threshold was not met and additional rounds of testing were undertaken.
  
  
  RESULTS
  At round 1, answers to 2/8 statements did not meet the threshold. After changes, answers in round 2 did not reach the threshold for 1/8 statements. In round 3, all answers were adequate and the leaflet was deemed fit-for-purpose. Qualitative data offered solutions such as language and layout changes which led to improved comprehension of the leaflet.
  
  
  CONCLUSIONS
  User-testing substantially improved the design and subsequent comprehensibility of a theory-driven gist-based colorectal cancer screening information leaflet.
  
  
  CONCLUSIONS
  This leaflet will be evaluated as part of a large national randomised controlled trial designed to reduce socioeconomic inequalities in colorectal cancer screening participation.
authors.affiliation: Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, UCL, London, UK. Electronic address: Samuel.smith@ucl.ac.uk.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Smith
authors.forename: Michael S
authors.initials: MS
authors.lastname: Wolf
authors.forename: Austin
authors.initials: A
authors.lastname: Obichere
authors.forename: Rosalind
authors.initials: R
authors.lastname: Raine
authors.forename: Jane
authors.initials: J
authors.lastname: Wardle
authors.forename: Christian
authors.initials: C
authors.lastname: von Wagner
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D032882:Comprehension; D055088:Early Detection of Cancer; D004739:England; D005260:Female; D017143:Fuzzy Logic; D057220:Health Literacy; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008960:Models, Psychological; D010174:Pamphlets; D011932:Reading
keywords: Colorectal cancer; Fuzzy-trace theory; Health literacy; Information design; Numeracy; Screening; User-testing