The development and testing of a brief ('gist-based') supplementary colorectal cancer screening information leaflet

Samuel G. Smith*, Michael S. Wolf, Austin Obichere, Rosalind Raine, Jane Wardle, Christian von Wagner

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

Objective: To design and user-test a 'gist-based' colorectal cancer screening information leaflet, which promotes comprehension of the screening offer. Methods: Twenty-eight individuals approaching screening age were recruited from organisations in deprived areas of England. Using a between-subjects design, we tested iterations of a newly-designed gist-based information leaflet. Participants read the leaflet and answered 8 'true' or 'false' comprehension statements. For the leaflet to be considered fit-for-purpose, all statements had to be answered correctly by at least 80% of participants in each round. Alterations were made if this threshold was not met and additional rounds of testing were undertaken. Results: At round 1, answers to 2/8 statements did not meet the threshold. After changes, answers in round 2 did not reach the threshold for 1/8 statements. In round 3, all answers were adequate and the leaflet was deemed fit-for-purpose. Qualitative data offered solutions such as language and layout changes which led to improved comprehension of the leaflet. Conclusion: User-testing substantially improved the design and subsequent comprehensibility of a theory-driven gist-based colorectal cancer screening information leaflet. Practical implications: This leaflet will be evaluated as part of a large national randomised controlled trial designed to reduce socioeconomic inequalities in colorectal cancer screening participation.

Original languageEnglish (US)
Pages (from-to)619-625
Number of pages7
JournalPatient education and counseling
Volume93
Issue number3
DOIs
StatePublished - Dec 2013

Funding

We acknowledge the support of ContinYou (Helen Baker and Janet Solla) and Social Action for Health (Susie Chrome) in the recruitment of study participants. We also acknowledge the support of the ASCEND team and the directors of the NHS Bowel Cancer Screening hubs for their support with the management and implementation of the wider research project. This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number RP-PG-0609-10106). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Mr Smith is supported by a PhD studentship from the Medical Research Council.

Keywords

  • Colorectal cancer
  • Fuzzy-trace theory
  • Health literacy
  • Information design
  • Numeracy
  • Screening
  • User-testing

ASJC Scopus subject areas

  • General Medicine

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