Methods: Adults ages 48-75 not currently up-to-date with screening were randomized to view one of two videos. One video (A) included an explicit discussion of not being screened; the other video (B) did not include an explicit statement that not being screened was an option. Both decision aid videos covered the same screening tests: fecal occult blood (FOBT) testing yearly, sigmoidoscopy every five years, a combination of FOBT and sigmoidoscopy, barium enema every 5 years, and colonoscopy every ten years. Screening interest was assessed before and after using a five-point Likert scale. The post-video questionnaire also included decision satisfaction and decisional conflict scales and selection of a screening test.

Results: 62 adults participated; 37 viewed A and 25 viewed B. Mean age was 55 years, 71% were women, 73% were White, 21% African-American, 95% had graduated high school. Most (55%) had not ever discussed CRC screening with their doctor. Prior to viewing, 26% indicated that they were definitely interested in being screened; after viewing, 39% were definitely interested in screening (p=0.0038). 32% responded to all knowledge questions correctly before, and 81% responded correctly (p=<0.0001) after viewing a video. Mean decisional conflict scores were low (1.8) and mean satisfaction scores were high (25.4). The most frequently selected test was colonoscopy, 46%.

Comparing responses among those who viewed video A versus video B, there were no differences in interest in being screened (2.00 vs. 1.84, p=0.5367) and number responding correctly to all knowledge questions before and after the videos (30% vs. 36% p=0.3929, 81% vs. 80% p=0.3479).Participants viewing video A scored it better in providing information about the possible disadvantages of screening than those viewing Version B (84% vs. 56%, p=0.0161). There were no differences in decisional conflict, satisfaction, or in test selected. Only one participant (who viewed video B) selected not to be screened.

Conclusions: Decision aids can increase knowledge and interest in screening. Inclusion of an explicit �no screening option� does not appear to affect interest. However, the video that included the �no screening option was rated as having better information on disadvantages.