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Development and preliminary evaluation of a bowel cancer screening decision aid for adults with lower literacy

Smith, Sian K., Trevena, Lyndal, Barratt, Alexandra, Dixon, Ann, Nutbeam, Donald, Simpson, Judy M. and McCaffery, Kirsten J. (2009) Development and preliminary evaluation of a bowel cancer screening decision aid for adults with lower literacy Patient Education and Counseling, 75, (3), pp. 358-367. (doi:10.1016/j.pec.2009.01.012).

Record type: Article


Objective: Several countries have recently implemented national bowel
cancer screening programs. To ensure equal access to screening,
information is needed to suit adults ranging in literacy level.
Decision aids are effective in providing balanced information and have
been applied in screening. However, few have been designed for
populations with lower education and literacy. This article describes
the development and preliminary evaluation of a bowel cancer screening
decision aid for this group.
Method: We conducted face-to-face interviews with adults of varying
literacy ability, to develop the decision aid (Stage I). We applied
principles of plain language, created visual illustrations to support
key textual messages, and used colour coding to direct the reader
through the booklet. We then explored its acceptability and
Comprehension among consumers with higher and lower education (Stage
2). Participants were recruited from a community sample with lower
education and a university alumni network.
Results: A total of 75 participants were interviewed, 43 with lower
educational attainment and 32 with university education. The decision
aid was positively reviewed by both education groups. Results
highlighted the need to clarify the purpose of the decision aid and the
availability of choice in the context of screening, especially to those
with lower education.
Conclusion: The 2 stage iterative development process identified
important factors to consider in the development of decision tools for
this target group, and is recommended.
Practice implications: Our findings have implications for how to
support people with lower education and literacy make informed
screening decisions.

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More information

Published date: June 2009
Organisations: Vice Chancellor Administration


Local EPrints ID: 154659
ISSN: 0738-3991
PURE UUID: b2fbbc87-ed5f-40d1-bc20-b8c2b90c66c9

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Date deposited: 26 May 2010 08:56
Last modified: 18 Jul 2017 12:46

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Author: Sian K. Smith
Author: Lyndal Trevena
Author: Alexandra Barratt
Author: Ann Dixon
Author: Donald Nutbeam
Author: Judy M. Simpson
Author: Kirsten J. McCaffery

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