Early Feedback for the Development of a Novel Brief Colon Cancer Screening Decision Aid for Adults ≥75 years at Risk for Limited Health Literacy: A Pilot Study.

IntroductionAchieving health literacy is a primary goal of Healthy People 2030 due to the increasing recognition of its role to improve the health and well-being of all populations. Shared decision-making (SDM), a recognized process between patients and health care providers to discuss which health care decision is best for the patient considering the pros and cons, patient preferences, and circumstances, can improve health outcomes. Specifically, SDM can increase patient knowledge and the quality of decision-making, resulting in patients feeling more empowered, demonstrating less decisional regret, and more motivation. Yet, limited health literacy (LHL) can hinder a patient's ability to engage in the SDM process. Patients' ability to engage in SDM can be helped by improving health literacy levels, and by the suitability of the tools available to support them. Decision aids (DA) are educational tools that can help with SDM. SDM provides patients with the necessary skills, which, when paired with DAs designed with and for populations with LHL, can improve communication with health care providers.MethodsGuided by elements of the Ottawa Decision Framework and principles of human-centered design, in this retrospective study we aimed to develop a novel and current brief colon cancer screening DA, "Making a Decision: Should I Stop or Continue Colon Cancer Screening - Ages 75-85," based on feedback from adults ≥75 years at risk for LHL in two focus groups and a comprehensive health literacy demand assessment of the "Making a Decision About Colon Cancer Screening" using four tools to determine its readability, understandability, and actionability.ResultsFindings include a DA that was viewed favorably by older adult participants who were at risk for LHL.ConclusionsWith feedback from older adults at risk for LHL, we have developed a DA that can be tested in a larger randomized control trial.