Tuesday, January 7, 2014: 1:30 PM
Royal Pavilion Ballroom I-III (The Regent Hotel)

Masahito Jimbo, MD, PhD, MPH1, Melissa Plegue, MA1, Ananda Sen, PhD1, Sarah T. Hawley, PhD, MPH2, Karen Kelly-Blake, PhD3 and Mack Ruffin IV, MD, MPH1, (1)University of Michigan, Ann Arbor, MI, (2)University of Michigan, Ann Arbor VA Health System, Ann Arbor, MI, (3)Michigan State University College of Human Medicine, East Lansing, MI
Purpose: Provide a preliminary baseline report on the impact of a web based decision aid (DA) on colorectal cancer (CRC) screening in a 4-year National Cancer Institute funded study (R01CA152413), Decision Aid to Technologically Enhance Shared Decision Making (DATES). 

Method: This is a 2-armed randomized controlled trial (target: 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 and 1 university-based primary care practices in Metro Detroit. Participants are adults aged 50 to 75 years, not current on CRC screening, and scheduled for a regular visit with their physicians. In the clinic before the patient-physician encounter, participants complete a Patient Baseline Survey before being randomized. 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). A 6-month chart audit is performed 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 agreement regarding test preference. Independent samples t-tests and Pearson's Chi-squared tests were used to compare the baseline demographic and web usage data between the arms. 

Result: So far, 258 participants have been recruited. Mean age + standard deviation 58.9 (6.9) years; racial distribution 44.1% Caucasian and 48.0% African American; gender distribution 52.5% women and 47.5% 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 NS between the 2 arms. Average duration of website usage is 23.9 minutes in the Control Arm vs. 25.6 minutes in the Intervention Arm (NS). 

Conclusion: The recruitment and randomization process have been 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.