Assignment: Preferred Screening Option

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Assignment: Preferred Screening Option

Assignment: Preferred Screening Option

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There was less consensus when asked about

implementation of the tool into routine clinical

practice. As shown in Table 2, <50% of

respondents agreed or strongly agreed that the

decision aid would be easy to use in their prac-

tice outside of a research setting or that it would

be used by most of their colleagues. A slim

majority (58%) also believed that implementa-

tion would require reorganization of their

practice. Respondents mostly agreed or were

neutral in their assessment of whether the deci-

sion aid should be disseminated as an Internet-

or DVD-based tool. When asked to identify a

preferred time for having their patients review

the tool (Table 3), 72% chose prior to initiating

the CRC screening discussion, 21% chose after

initiating the screening discussion, and 7% chose

both

Among the 21 providers who chose the

pre-visit approach, 13 preferred that the tool be

used in the office just prior to the pre-arranged

visit, five preferred at home use and three pre-

ferred both; among the six providers who chose

the post-visit approach, five preferred in-office

use and one preferred at home use.

There was also a lack of consensus when

asked about content modification. Whereas 50%

of respondents agreed or strongly agreed that

the decision aid should include a discussion of

costs, 31% disagreed or strongly disagreed

Table 2 Provider perspectives on decision aid implementation

The decision aid

Response category, n (%)

Mean item

score (SD)*

Strongly

agree ⁄ agree Neutral

Strongly

disagree ⁄ disagree

16. Would be easy to use in my practice

outside of a research stetting

12 (48) 9 (36) 4 (16) 3.4 ± 1.0

17. Use would require reorganization of my

practice for routine clinical use

14 (58) 6 (25) 4 (17) 3.6 ± 1.1

18. Is likely to be used by most of my colleagues 11 (41) 12 (44) 4 (15) 3.4 ± 0.9

19. Should include a discussion of costs 13 (50) 5 (19) 8 (31) 3.5 ± 1.2

20. Should be disseminated as an Internet-based tool 17 (63) 8 (30) 2 (7) 3.7 ± 0.9

21. Should be disseminated as a DVD-based tool 15 (56) 8 (30) 4 (15) 3.6 ± 0.9

DVD, digital video disc; SD, standard deviation.

*1 = strongly disagree; 5 = strongly agree.

Table 3 Preferences for clinical use and content modification

Item N (%)

22. When would you want your patient to

view the decision aid:

Before initiating CRC screening discussion

(pre-visit)

21 (72)

After initiating CRC discussion (post-visit) 6 (21)

Both 2 (7)

23. Would you prefer the decision aid to

contain information about:

All of the recommended screening options 15 (52)

A more restricted list of options 12 (41)

No opinion 2 (7)

CRC, colorectal cancer.

Colorectal cancer screening decision aid, P C Schroy, S Mylvaganam and P Davidson

� 2011 John Wiley & Sons Ltd Health Expectations, 17, pp.27–35

31

(Table 2). Similarly, whereas 52% of providers

preferred that the decision aid include a discus-

sion of all of the recommended screening

options, 41% preferred a more restricted list of

options and 7% had no opinion on the issue

(Table 3).

Only seven providers made suggestions for

improving the current decision aid. These

included creating non-English versions of the

tool (n = 2), clearly distinguishing colonoscopy

as the best screening option (n = 2), enabling

patients to print out their preferred screening

option (n = 2), and taking into consideration

that patients may not have access to the Internet

at home if the decision aid was to be dissemi-

nated as a web-based tool (n = 1). There were

no complaints.

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