title: An entertainment-education colorectal cancer screening decision aid for African American patients: A randomized controlled trial.
abstract: BACKGROUND
  Colorectal cancer screening rates for African American patients remain suboptimal. Patient decision aids designed with an entertainment-education approach have been shown to improve saliency and foster informed decision making. The purpose of this study was to assess whether an entertainment-education decision aid tailored for African American patients improved patients' decision making, attitudes, intentions, or colorectal cancer screening behavior.
  
  
  METHODS
  Eighty-nine participants were randomized to view 1) a patient decision aid video containing culturally tailored information about colorectal cancer screening options and theory-based support in decision making presented in an entertainment-education format or 2) an attention control video about hypertension that contained similarly detailed information. Participants met with their clinician and then completed follow-up questionnaires assessing their knowledge, decisional conflict, self-advocacy, attitudes, perceived social norms, and intentions. At 3 months, completion of screening was assessed by chart review.
  
  
  RESULTS
  Viewing the culturally tailored decision aid significantly increased African American patients' knowledge of colorectal cancer screening recommendations and options. It also significantly reduced their decisional conflict and improved their self-advocacy. No significant differences were observed in participants' attitudes, norms, or intentions. At three months, 23% of all patients had completed a colonoscopy.
  
  
  CONCLUSIONS
  Designing targeted, engaging patient decision aids for groups that receive suboptimal screening holds promise for improving patient decision making and self-advocacy. Additional research is warranted to investigate the effectiveness of such aids in clinical practices with suboptimal screening rates and on downstream behaviors (such as repeat testing). Cancer 2017;123:1401-1408. © 2016 American Cancer Society.
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Aubri S
authors.initials: AS
authors.lastname: Hoffman
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Lowenstein
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Geetanjali R
authors.initials: GR
authors.lastname: Kamath
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Ashley J
authors.initials: AJ
authors.lastname: Housten
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Viola B
authors.initials: VB
authors.lastname: Leal
authors.affiliation: Division of Rehabilitation Sciences, The University of Texas Medical Branch at Galveston, Galveston, Texas.
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Linder
authors.affiliation: School of Allied Health Sciences, Baylor College of Medicine, Houston, Texas.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Jibaja-Weiss
authors.affiliation: Department of Gastroenterology, Hepatology & Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Gottumukkala S
authors.initials: GS
authors.lastname: Raju
authors.affiliation: Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Volk
mesh_terms: D001741:Black or African American; D000368:Aged; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D003469:Culture; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010353:Patient Education as Topic; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: African American; choice behaviors; colorectal cancer; decision aids; screening