ACCEPTABILITY AND EFFICACY OF A VIDEO-BASED PATIENT DECISION AID ABOUT LUNG CANCER SCREENING WITH LOW-DOSE COMPUTED TOMOGRAPHY

Purpose:   We evaluated the acceptability and initial efficacy of a video-based patient decision aid about lung cancer screening with low-dose computed tomography (CT).

Method:   A multipronged strategy was used to recruit smokers, including contacting patients from the Tobacco Treatment Program at MD Anderson Cancer Center, placing advertisements in the local newspapers, and relying on referrals from existing participants in the study. Eligible subjects included English-speaking men and women ages 55 to 80 years who were either current smokers or had quit within the past 15 years and had no history of lung cancer. Subjects were given a link to an online survey where they completed a pre-intervention assessment, viewed the decision aid video “Lung Cancer Screening: Is it right for me?", and completed a post-intervention assessment. Questions from the Ottawa Acceptability Measures* were completed after viewing the decision aid. Subjects also completed a 14-item pre/post knowledge questionnaire, and at the post-test assessment the Values Clarity subscale of the Decisional Conflict Scale (DCS)*, and the Preparation for Decision Making Scale*. 

Result:   Surveys were completed by all 30 subjects. Twenty (66.7%) were current smokers and the remainder were former smokers. Average pack-year smoking history was 30.4 years. Nine (30%) identified themselves as African American, 19 (63.3%) as Caucasian, 1 as Hispanic (3.3%) and 1 as other (3.3%). All 30 subjects viewed the entire video and rated the amount of information. Over 90% rated the aid as balanced in presentation of harms and benefits, the length of the aid as “just right,” and most or all the information clearly presented. The mean knowledge score at the baseline was 5.67 (SD=2.50) on the 12-item measure, and at the follow-up was 9.63 (SD=1.56, P<.001). The mean score on the Values Clarity subscale of the DCS was 6.66 (SD=16.13), and subjects scored 77.2 out of 100 on the Preparation for Decision Making Scale. 

Conclusion:   Our video-based patient decision aid about lung cancer screening was rated favorably by current and former smokers. Initial evidence of efficacy of the aid was demonstrated by significant improvements in smokers’ knowledge of lung cancer screening, low decisional conflict, and high readiness for decision making. The video format is highly adaptable for use in multiple settings.

*Copyright, Ottawa Hospital Research Institute.