Shared Decision-Making for Colorectal Cancer Screening
Condition: Colorectal Cancer
MeSH terms: Colorectal Neoplasms
Study type: Interventional

Summary: 
      The overall objective of this study is to conduct a three-arm randomized controlled trial to
      evaluate the impact of an interactive, web-based decision aid on shared decision-making and
      patient adherence to colorectal cancer (CRC) screening recommendations.
    

Detailed description: 
      Colorectal cancer (CRC) is the second leading cause of cancer-related death and third most
      commonly diagnosed cancer among men and women in the United States. Screening has been shown
      to be a cost-effective strategy for reducing both CRC mortality through early detection and
      incidence through the detection and removal of precancerous adenomatous polyps (adenomas).
      Despite a compelling rationale and widespread endorsement by authoritative groups, screening
      rates remain far below those necessary to achieve significant reductions in CRC mortality or
      incidence. Poor patient acceptance and non-adherence to screening recommendations are partly
      responsible for low screening rates. Shared decision-making has been advocated as a
      potentially effective yet unproven strategy for addressing this problem. Implicit in this
      approach is the need for an unbiased decision aid that not only educates patients about the
      pros and cons of the different strategies so as to enable them to identify a preferred
      strategy but also empowers patients to take a proactive role in the decision-making process,
      thereby increasing satisfaction and promoting adherence. From a logistical standpoint, the
      decision aid must also be easy to implement in the ambulatory setting so as to maximize use
      but minimize demands on physician time and office resources. To address this need, we have
      developed an interactive, web-based decision aid and implementation strategy for use in
      routine clinical practice.

      Comparison(s): Average risk subjects assigned to one of two intervention arms (decision aid
      alone versus decision aid plus personalized risk assessment with feedback) compared to a
      control arm(generic website that discusses lifestyle changes that can reduce overall cancer
      risk).
    

Intervention name(s): Web-based decision aid plus personalized risk assessment; Web-based decision aid alone; Generic website
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): Patients review a computer-based decision aid that discuss the pros and cons of of 5 recommended CRC screening options and provides personalized 10-year estimates of CRC risk prior to meeting with their provider to discuss CRC screening.; Patients review a computer-based decision aid that discuss the pros and cons of the 5 recommended CRC screening options prior to meeting with their provider to discuss CRC screening.; Patients review a generic website that discuss ways to reduce overall cancer risk.
Other intervention name(s): Decision aid, personalized risk assessment tool; Decision aid; Control condtion
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Care Provider)
Primary purpose: Prevention
Keywords: Colorectal cancer screening; Shared decision-making; Decision aid