Investigation of a multimedia, computer-based approach to improve knowledge, attitudes, self-efficacy, and receptivity to cancer clinical trials among newly diagnosed patients with diverse health literacy skills

Blase N. Polite, Toni M. Cipriano-Steffens*, Chuanhong Liao, Edward L. Miller, Nicole L. Arndt, Elizabeth A Hahn

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Enrollment in therapeutic cancer trials remains low, and is especially challenging for patients with low health literacy. The authors tested an interactive technology designed for patients with diverse health literacy skills with the aim of improving patient receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials. Methods: Patients presenting for their first oncology appointment were eligible. Patients viewed an interactive teaching video concerning clinical trials that was adapted from the National Institutes of Health. Validated surveys assessing receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials were administered before and after the test. Results: A total of 120 patients with cancer were enrolled. Approximately 80% were non-Hispanic white, 33% were female, 69% had >high school education, and 8% reported an income <$20,000. Approximately 33% scored within the low health literacy range. Changes between pretest and posttest demonstrated increases in knowledge (P <.001), self-efficacy (P <.001), and positive beliefs (P =.004); a slight decrease in willingness (P =.009); and no difference in patient receptivity (P =.31). Higher health literacy was associated with improved willingness (P =.049) and non-Hispanic white race was associated with improved receptivity (P =.034). Conclusions: Interactive technology that was designed for patients with diverse health literacy skills demonstrated the ability to improve knowledge, self-efficacy, and positive beliefs regarding cancer clinical trials. Contrary to the hypothesis of the current study, patients with lower health literacy did not appear to derive a greater advantage from this technology. There was no improvement noted with regard to patient willingness or receptivity, and clinical trial enrollment remained at historical institutional levels. Talking touchscreen technology has a potential role as an important element in informed decision making for patients, but likely needs to be coupled with more robust and multitargeted interventions.

Original languageEnglish (US)
Pages (from-to)2066-2075
Number of pages10
JournalCancer
Volume125
Issue number12
DOIs
StatePublished - Jun 15 2019

Fingerprint

Health Literacy
Multimedia
Self Efficacy
Clinical Trials
Neoplasms
Technology
Aptitude
National Institutes of Health (U.S.)
Decision Making
Appointments and Schedules
Teaching

Keywords

  • clinical trials enrollment
  • communication
  • health care disparities
  • low health literacy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{d3a7fc01e45942b09676e154502a6f1f,
title = "Investigation of a multimedia, computer-based approach to improve knowledge, attitudes, self-efficacy, and receptivity to cancer clinical trials among newly diagnosed patients with diverse health literacy skills",
abstract = "Background: Enrollment in therapeutic cancer trials remains low, and is especially challenging for patients with low health literacy. The authors tested an interactive technology designed for patients with diverse health literacy skills with the aim of improving patient receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials. Methods: Patients presenting for their first oncology appointment were eligible. Patients viewed an interactive teaching video concerning clinical trials that was adapted from the National Institutes of Health. Validated surveys assessing receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials were administered before and after the test. Results: A total of 120 patients with cancer were enrolled. Approximately 80{\%} were non-Hispanic white, 33{\%} were female, 69{\%} had >high school education, and 8{\%} reported an income <$20,000. Approximately 33{\%} scored within the low health literacy range. Changes between pretest and posttest demonstrated increases in knowledge (P <.001), self-efficacy (P <.001), and positive beliefs (P =.004); a slight decrease in willingness (P =.009); and no difference in patient receptivity (P =.31). Higher health literacy was associated with improved willingness (P =.049) and non-Hispanic white race was associated with improved receptivity (P =.034). Conclusions: Interactive technology that was designed for patients with diverse health literacy skills demonstrated the ability to improve knowledge, self-efficacy, and positive beliefs regarding cancer clinical trials. Contrary to the hypothesis of the current study, patients with lower health literacy did not appear to derive a greater advantage from this technology. There was no improvement noted with regard to patient willingness or receptivity, and clinical trial enrollment remained at historical institutional levels. Talking touchscreen technology has a potential role as an important element in informed decision making for patients, but likely needs to be coupled with more robust and multitargeted interventions.",
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author = "Polite, {Blase N.} and Cipriano-Steffens, {Toni M.} and Chuanhong Liao and Miller, {Edward L.} and Arndt, {Nicole L.} and Hahn, {Elizabeth A}",
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Investigation of a multimedia, computer-based approach to improve knowledge, attitudes, self-efficacy, and receptivity to cancer clinical trials among newly diagnosed patients with diverse health literacy skills. / Polite, Blase N.; Cipriano-Steffens, Toni M.; Liao, Chuanhong; Miller, Edward L.; Arndt, Nicole L.; Hahn, Elizabeth A.

In: Cancer, Vol. 125, No. 12, 15.06.2019, p. 2066-2075.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Investigation of a multimedia, computer-based approach to improve knowledge, attitudes, self-efficacy, and receptivity to cancer clinical trials among newly diagnosed patients with diverse health literacy skills

AU - Polite, Blase N.

AU - Cipriano-Steffens, Toni M.

AU - Liao, Chuanhong

AU - Miller, Edward L.

AU - Arndt, Nicole L.

AU - Hahn, Elizabeth A

PY - 2019/6/15

Y1 - 2019/6/15

N2 - Background: Enrollment in therapeutic cancer trials remains low, and is especially challenging for patients with low health literacy. The authors tested an interactive technology designed for patients with diverse health literacy skills with the aim of improving patient receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials. Methods: Patients presenting for their first oncology appointment were eligible. Patients viewed an interactive teaching video concerning clinical trials that was adapted from the National Institutes of Health. Validated surveys assessing receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials were administered before and after the test. Results: A total of 120 patients with cancer were enrolled. Approximately 80% were non-Hispanic white, 33% were female, 69% had >high school education, and 8% reported an income <$20,000. Approximately 33% scored within the low health literacy range. Changes between pretest and posttest demonstrated increases in knowledge (P <.001), self-efficacy (P <.001), and positive beliefs (P =.004); a slight decrease in willingness (P =.009); and no difference in patient receptivity (P =.31). Higher health literacy was associated with improved willingness (P =.049) and non-Hispanic white race was associated with improved receptivity (P =.034). Conclusions: Interactive technology that was designed for patients with diverse health literacy skills demonstrated the ability to improve knowledge, self-efficacy, and positive beliefs regarding cancer clinical trials. Contrary to the hypothesis of the current study, patients with lower health literacy did not appear to derive a greater advantage from this technology. There was no improvement noted with regard to patient willingness or receptivity, and clinical trial enrollment remained at historical institutional levels. Talking touchscreen technology has a potential role as an important element in informed decision making for patients, but likely needs to be coupled with more robust and multitargeted interventions.

AB - Background: Enrollment in therapeutic cancer trials remains low, and is especially challenging for patients with low health literacy. The authors tested an interactive technology designed for patients with diverse health literacy skills with the aim of improving patient receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials. Methods: Patients presenting for their first oncology appointment were eligible. Patients viewed an interactive teaching video concerning clinical trials that was adapted from the National Institutes of Health. Validated surveys assessing receptiveness, willingness, knowledge, self-efficacy, and positive attitudes regarding clinical trials were administered before and after the test. Results: A total of 120 patients with cancer were enrolled. Approximately 80% were non-Hispanic white, 33% were female, 69% had >high school education, and 8% reported an income <$20,000. Approximately 33% scored within the low health literacy range. Changes between pretest and posttest demonstrated increases in knowledge (P <.001), self-efficacy (P <.001), and positive beliefs (P =.004); a slight decrease in willingness (P =.009); and no difference in patient receptivity (P =.31). Higher health literacy was associated with improved willingness (P =.049) and non-Hispanic white race was associated with improved receptivity (P =.034). Conclusions: Interactive technology that was designed for patients with diverse health literacy skills demonstrated the ability to improve knowledge, self-efficacy, and positive beliefs regarding cancer clinical trials. Contrary to the hypothesis of the current study, patients with lower health literacy did not appear to derive a greater advantage from this technology. There was no improvement noted with regard to patient willingness or receptivity, and clinical trial enrollment remained at historical institutional levels. Talking touchscreen technology has a potential role as an important element in informed decision making for patients, but likely needs to be coupled with more robust and multitargeted interventions.

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KW - communication

KW - health care disparities

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