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


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
Issue number3
StatePublished - Dec 2013


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

ASJC Scopus subject areas

  • General Medicine


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