Development of a decision aid to support colorectal cancer screening: perspectives of Asians in an endemic urban community-a qualitative research study.

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  • Author(s): Yuen SWJ;Yuen SWJ; Tay TY; Tay TY; Gao N; Gao N; Tho NQ; Tho NQ; Tan NC; Tan NC; Tan NC
  • Source:
    BMC medical informatics and decision making [BMC Med Inform Decis Mak] 2021 Mar 06; Vol. 21 (1), pp. 86. Date of Electronic Publication: 2021 Mar 06.
  • Publication Type:
    Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088682 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6947 (Electronic) Linking ISSN: 14726947 NLM ISO Abbreviation: BMC Med Inform Decis Mak Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Colorectal Neoplasms*/diagnosis ; Early Detection of Cancer*; Adult ; Asian People ; Decision Support Techniques ; Health Knowledge, Attitudes, Practice ; Humans ; Middle Aged ; Qualitative Research ; Singapore
    • Abstract:
      Background: Colorectal cancer (CRC) is a common malignancy worldwide. Despite being the most common cancer in Singapore, CRC screening rate remains low due to knowledge deficits, social reasons such as inconvenience and a lack of reminder or recommendation. A decision aid (DA) may facilitate an individual's decision-making to undertake CRC screening by addressing misconceptions and barriers. We postulate that a more person-centred and culturally adapted DA will better serve the local population. The views of the target users are thus needed to develop such a DA. A CRC screening DA prototype has been adapted from an American DA to cater to the Asian users. This study aimed to explore user perspectives on an adapted CRC screening DA-prototype in terms of the design, content and perceived utility.
      Methods: The study used in-depth interviews (IDIs) and focus group discussions (FGDs) to gather qualitative data from English-literate multi-ethnic Asian adults aged 50 years old and above. They had yet to screen for CRC before they were recruited from a public primary care clinic in Singapore. The interviews were audio-recorded, transcribed and analysed to identify emergent themes via thematic analysis.
      Results: This study included 27 participants involved in 5 IDI and 5 FGDs. Participants found the DA easily comprehensible and of appropriate length. They appreciated information about the options and proposed having multi-lingual DAs. The design, in terms of the layout, size and font, was well-accepted but there were suggestions to digitalize the DA. Participants felt that the visuals were useful but there were concerns about modesty due to the realism of the illustration. They would use the DA for information-sharing with their family and for discussion with their doctor for decision making. They preferred the doctor's recommendation for CRC screening and initiating the use of the DA.
      Conclusions: Participants generally had favourable perceptions of the DA-prototype. A revised DA will be developed based on their feedback. Further input from doctors on the revised DA will be obtained before assessing its effectiveness to increase CRC screening rate in a randomized controlled trial.
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    • Contributed Indexing:
      Keywords: Colorectal cancer; Content; Decision aid; Design; Screening; Utility
    • Publication Date:
      Date Created: 20210307 Date Completed: 20210423 Latest Revision: 20240331
    • Publication Date:
      20240331
    • Accession Number:
      PMC7936439
    • Accession Number:
      10.1186/s12911-021-01404-1
    • Accession Number:
      33676504