Method: This is a 2-armed randomized controlled trial with a target of 300 patients per arm. Intervention Arm features DATES Web, the interactive DA that elicits patient risk for CRC and clarifies preference for a specific CRC screening test option. Control Arm features a web-based DA with the same information but without the interactive features. Setting is 10 community primary care practices in Metro Detroit. Participants are adults aged 50 to 75 years, not current on CRC screening, and scheduled for check-up or chronic care visit with their physicians. In the clinic before the patient-physician encounter, participants complete a Patient Baseline Survey. They are randomized to DATES Web or the control website. Data are collected after the patient reviews the respective website (Post-Intervention Survey), during the patient-physician encounter (digital audio recording) and after it (Post-Encounter Survey). Chart audit is performed 6 months after the encounter to determine whether the patient underwent CRC screening. Primary outcomes are: patient uptake of CRC screening; patient decision quality (knowledge, preference clarification, intent); degree of shared decision making; and patient-physician concordance regarding test preference.
Result: As of May 13, 2013, 183 participants have been recruited. Mean age + standard deviation is 58.3+6.3 years; racial distribution is 47.8% Caucasian and 45.7% African American; and gender distribution is 53.6% women and 46.4% men, difference between the 2 arms statistically not significant (NS). Differences in knowledge, attitude, perceived self-efficacy, decision-making preference, and test preference at baseline are statistically not significant between the 2 arms. Average duration of website usage is 24’44.3” in the Control Arm vs. 23’55.2” in the Intervention Arm (NS).
Conclusion: The recruitment and randomization process have been so far successful. The results of our study will be among the first to examine the effect of a real-time preference assessment exercise on CRC screening and mediators, and, in doing so, will shed light on the patient-physician communication and shared decision making "black box" that currently exists between the delivery of DAs to patients and the subsequent patient behavior.