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The LEAD trial. The effectiveness of a decision aid on decision making among citizens with lower educational attainment who have not participated in FIT-based colorectal cancer screening in Denmark: a randomised controlled trial

Gabel, Pernille, Edwards, Adrian, Kirkegaard, Pia, Larsen, Mette Bach and Andersen, Berit 2020. The LEAD trial. The effectiveness of a decision aid on decision making among citizens with lower educational attainment who have not participated in FIT-based colorectal cancer screening in Denmark: a randomised controlled trial. Patient Education and Counseling 103 (2) , pp. 359-368. 10.1016/j.pec.2019.08.029

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Abstract

Objectives This trial tested the effectiveness of a self-administered web-based decision aid, targeted at citizens with lower educational attainment, on informed choice about colorectal cancer screening participation as assessed by group levels of knowledge, attitudes and uptake. Methods The randomised controlled trial was conducted among 2702 screening-naïve Danish citizens, 53–74 years old, with lower educational attainment. Baseline questionnaire respondents (62%) were allocated to intervention and control groups. Intervention group citizens received the decision aid. Outcomes were informed choice, worries and decisional conflict. Results Analyses were conducted among 339 eligible citizens. The mean difference in knowledge score change between intervention and control group was 0.00 (95% confidence interval (CI): -0.38;0.38). Trends towards more positive screening attitudes (mean difference in score change: 0.72, 95% CI: -0.38;1.81) and higher screening uptake (7.6%, 95% CI:−2.2;17.4%) were observed. Worries (−0.33, 95% CI: −0.97;0.32) and decisional conflict (mean difference: −3.5, 95%CI: −7.0;−0.1) were slightly reduced. Conclusions The decision aid did not affect informed choice or knowledge. However, there were trends towards increased screening uptake and more positive screening attitudes. Practice implications Being a simple intervention and easily administered, the decision aid could represent a cost-effective way of enhancing screening uptake, and some elements of informed decision-making.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Elsevier
ISSN: 0738-3991
Funders: The Danish Foundation TrygFonden, The Danish Cancer Society, The Health Research Fund of Central Denmark Region, Health, Aarhus University, The Private Foundation of the Family Spogard, The Health Foundation Denmark, Danish Cancer Research Foundation, The Private Foundation of Ringgaard-Bohn, The Danish Health Authority
Date of First Compliant Deposit: 19 August 2019
Date of Acceptance: 18 August 2019
Last Modified: 14 Feb 2020 13:00
URI: http://orca.cf.ac.uk/id/eprint/124999

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