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.
KW - clinical trials enrollment
KW - communication
KW - health care disparities
KW - low health literacy
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U2 - 10.1002/cncr.31991
DO - 10.1002/cncr.31991
M3 - Article
C2 - 30811591
AN - SCOPUS:85062351116
VL - 125
SP - 2066
EP - 2075
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 12
ER -