Effectiveness of Colorectal Cancer Screening Promotion Using E-Media Decision Aids: A Systematic Review and Meta-Analysis

Abstract

Colorectal cancer (CRC)-screening reduces mortality, yet remains underutilized. The use of electronic media (e-media) decision aids improves saliency and fosters informed decision-making. This systematic review aimed to determine the effectiveness of CRC-screening promotion, using e-media decision aids in primary healthcare (PHC) settings. Three databases (MEDLINE, Web of Science, and the Cochrane Library) were searched for eligible studies. Studies that evaluated e-media decision aids compared to usual care or other conditions were selected. Quality was assessed by using Cochrane tools. Their effectiveness was measured by CRC-screening completion rates, and meta-analysis was conducted to calculate the pooled estimates. Ten studies involving 9393 patients were included in this review. Follow-up durations spanned 3–24 months. The two types of decision-aid interventions used were videos and interactive multimedia programs, with durations of 6–15 min. Data from nine feasible studies with low or some risk of bias were synthesized for meta-analysis. A random-effects model revealed that CRC-screening promotion using e-media decision aids were almost twice as likely to have screening completion than their comparisons (OR 1.62, 95% CI: 1.03–2.62, p < 0.05). CRC-screening promotion through e-media has great potential for increasing screening participation in PHC settings. Thus, its development should be prioritized, and it should be integrated into existing programs.

A Double-Edged Sword: Quality and Credibility of Colon Cancer Screening Content on YouTube

“…While its high traffic and broad reach make it a potent channel for public health campaigns, healthcare providers must be mindful of its limitations in patient education. A meta-analysis revealed that videos and multimedia programs significantly encourage CRC screening, enhancing completion rates [ 38 ]. However, a study noted that while YouTube's CRC education videos are high in production quality, their accountability and content scores vary greatly.…”

“…It is crucial for these videos to directly address the most prevalent questions and stigmas related to colorectal screening, ensuring that they are highly relevant and engaging. Health initiatives for CRC should aim to enhance understanding, alleviate fears and distrust, and promote CRC screening as a vital preventive measure, particularly focusing on older adults [ 38 ]. Employing pop-up ads with concise, catchy phrases that tackle common misconceptions or stigmas can significantly boost CRC screening awareness among the general population [ 40 ].…”