Aims: Colon cancer screening rates are lower than targeted in Ontario. Further investigation indicated that a large proportion of the under and never screened population is illiterate and that the written fecal occult blood test (FOBT) instructions are too complex and wordy for illiterate, low literacy, and English as a second language populations. Our purpose was to develop a humourous FOBT instructional video to overcome this barrier.
Methods: The Ontario FOBT written instructions were used as the basis for the instructional video script. Artist sketches and group consensus was used to develop an appropriate character. An iterative process with focus group feedback was used to work towards a final video.
Results: Various versions of the video were tested on the regional under/never screened project teams (physicians, nurses, outreach workers), rural community members (n=7 groups), small town (n=4), and suburban community members (n=2 groups). Men had a strong and uniformly positive reaction to the video, requesting that it be on TV and stating that it was “Superbowl brilliant”. Women’s reactions ranged from reserved positive to strongly positive. All felt confident and optimistic about performing the test after watching the video. Family health team clinicians indicated they wanted the animation on loop in their clinic waiting areas.
Conclusions: Providing an uncomplicated, humourous instructional video can increase awareness of cancer screening, alleviate test fear, increase confidence in performing test, and change attitudes towards screening.