BMC Med Inform Decis Mak - Protocol for population testing of an Internet-based Personalised Decision Support system for colorectal cancer screening.


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CKGROUND: Australia has a comparatively high incidence of colorectal (bowel) cancer; however, population screening uptake using faecal occult blood test (FOBT) remains low. This study will determine the impact on screening participation of a novel, Internet-based Personalised Decision Support (PDS) package. The PDS is designed to measure attitudes and cognitive concerns and provide people with individually tailored information, in real time, that will assist them with making a decision to screen. The hypothesis is that exposure to (tailored) PDS will result in greater participation in screening than participation following exposure to non-tailored PDS or resulting from the current non-tailored, paper-based approach.METHODS/DESIGN: A randomised parallel trial comprising three arms will be conducted. Men and women aged 50-74 years (N = 3240) will be recruited. They must have access to the Internet; have not had an FOBT within the previous 12 months, or sigmoidoscopy or colonoscopy within the previous 5 years; have had no clinical diagnosis of bowel cancer. Groups 1 and 2 (PDS arms) will access a website and complete a baseline survey measuring decision-to-screen stage, attitudes and cognitive concerns and will receive immediate feedback; Group 1 will receive information 'tailored' to their responses in the baseline survey and group 2 will received 'non-tailored' bowel cancer information. Respondents in both groups will subsequently receive an FOBT kit. Group 3 (usual practice arm) will complete a paper-based version of the baseline survey and respondents will subsequently receive 'non-tailored' paper-based bowel cancer information with accompanying FOBT kit. Following despatch of FOBTs, all respondents will be requested to complete an endpoint survey. Main outcome measures are (1) completion of FOBT and (2) change in decision-to-screen stage. Secondary outcomes include satisfaction with decision and change in attitudinal scores from baseline to endpoint. Analyses will be performed using Chi-square tests, analysis of variance and log binomial generalized linear models as appropriate.DISCUSSION: It is necessary to restrict participants to Internet users to provide an appropriately controlled evaluation of PDS. Once efficacy of the approach has been established, it will be important to evaluate effectiveness in the wider at-risk population, and to identify barriers to its implementation in those settings.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12610000095066.

Resumo Limpo

ckground australia compar high incid colorect bowel cancer howev popul screen uptak use faecal occult blood test fobt remain low studi will determin impact screen particip novel internetbas personalis decis support pds packag pds design measur attitud cognit concern provid peopl individu tailor inform real time will assist make decis screen hypothesi exposur tailor pds will result greater particip screen particip follow exposur nontailor pds result current nontailor paperbas approachmethodsdesign randomis parallel trial compris three arm will conduct men women age year n will recruit must access internet fobt within previous month sigmoidoscopi colonoscopi within previous year clinic diagnosi bowel cancer group pds arm will access websit complet baselin survey measur decisiontoscreen stage attitud cognit concern will receiv immedi feedback group will receiv inform tailor respons baselin survey group will receiv nontailor bowel cancer inform respond group will subsequ receiv fobt kit group usual practic arm will complet paperbas version baselin survey respond will subsequ receiv nontailor paperbas bowel cancer inform accompani fobt kit follow despatch fobt respond will request complet endpoint survey main outcom measur complet fobt chang decisiontoscreen stage secondari outcom includ satisfact decis chang attitudin score baselin endpoint analys will perform use chisquar test analysi varianc log binomi general linear model appropriatediscuss necessari restrict particip internet user provid appropri control evalu pds efficaci approach establish will import evalu effect wider atrisk popul identifi barrier implement settingstri registr australian new zealand clinic trial registri actrn

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