Developing a Computer Touch-Screen Interactive Colorectal Screening Decision Aid for a Low-Literacy African American Population

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.

Randomized Trial of a Computerized Touch Screen Decision Aid to Increase Acceptance of Colonoscopy Screening in an African American Population with Limited Literacy

“…A challenge is to document how individuals gather information about the identity, causes, patterns, consequences, and controllability of health problems, to form major components of their “representations” or mental models of a health problem (Leventhal et al, 2004), and then to demonstrate how prevention methods crafted to reflect these models increase preventive health practices. This study links these processes and has documented the process by which the CDA was developed from the models (Bass et al, 2013). The large effect size of the CDA in terms of intent to screen provides empirical evidence that using this theoretical formulation can yield important clinical outcomes.…”

“…Details of the process used to develop the CDA have been published previously (Bass et al, 2013), as has the analysis of perceptual mapping variables used in it (Gordon et al, 2014). Using a k -means cluster analysis, perceptual mapping, and vector message modeling analysis we developed the CDA in collaboration with the Patient Education Institute (PEI).…”

Using theory and user‐centered design in digital health: The development of the mychoice communication tool to prepare patients and improve informed decision making regarding clinical trial participation

“…Perceptual mapping analysis by clinical trial status was conducted to prioritize relevant factors associated with clinical trial participation and ultimately guide message prioritization. Based on the Galileo approach of Woelfel and Fink, the perceptual mapping analysis uses multi‐dimensional scaling to produce 3‐dimensional models to illustrate how groups perceive of a decision or medical threat and been applied to a number of health decisions by the authors . To create the maps, our computer software converts the scaled 0‐10 ratings into distances, derived from the inter‐item correlations.…”

How Do Low-Literacy Populations Perceive “Dirty Bombs”? Implications for Preparedness Messages

“…(For further in-depth information on these methods, see: https:// sites.temple.edu/turiskcommlab/). 57,[59][60][61] To construct the perceptual maps we used Cogniplot, a software program the authors developed based on the multidimensional scaling program Galileo. 62 Survey data were rendered in distance matrix form for input into Cogniplot.…”