Aims: A randomised controlled trial tested whether personalised and online decision support, tailored on psychological variables and stage of change, resulted in better participation in screening for CRC than non-tailored on-line and traditional paper-based educational resources. Results were explored through focus groups at study conclusion.
Methods: Baseline surveys were distributed to people randomised to groups of 1135 Control, 1136 Non-tailored computer, and 1137 Tailored computer invitees. Surveys were returned by 76%, 64% and 66% of each group respectively. Participants completed a questionnaire online, or a paper-based questionnaire, in accordance with the condition they had been assigned. The variables included were from the Preventive Health Model. Those in the Tailored computer condition received feedback tailored to their responses to these variables and to their stage of readiness to screen. Subsequent invitations to screen with a faecal occult blood test were accompanied by either paper-based bowel cancer information (Control group only), or access to information via the online tool. At study conclusion, 4 focus groups were conducted with 32 participants, sampled using a maximum variability framework based on tailoring (yes/no), gender and age. Transcripts were analysed using a Framework Analysis.
Results: Participation differed significantly between the conditions [χ2 (2) = 13.81, p<.001] with participation rates of 74.1%, 81.7% and 79.4% for Control, Non-tailored and Tailored conditions respectively. Tailored [OR=1.35, CI95=1.06-1.71] and Non-tailored condition [OR=1.56, CI95=1.22-1.99] participants had higher odds of completing the FOBT. Qualitative data revealed that the tailored website was viewed as a “test” that participants either passed or failed, causing anger and frustration in some participants.
Conclusion: Web-based decision support had a positive impact on FOBT participation rates; tailored online information delivered provided no additional advantage.