Process Evaluation of a Mailed Interactive Educational DVD in a Comparative Effectiveness Trial to Promote Colorectal Cancer Screening

Abstract

A process evaluation was conducted as part of a comparative effectiveness trial of a mailed interactive educational DVD intervention to promote colorectal cancer screening among average-risk patients who did not attend a scheduled colonoscopy. Participants (n = 371) for the trial were randomized to (1) mailed DVD, (2) mailed DVD plus patient navigation, or (3) usual care. Participants (n = 243) randomized to the two DVD intervention arms were called 2 weeks after mailing materials to complete a process evaluation interview about the DVD (September 2017–February 2020). Forty-nine (20%) participants were not reached, and 194 (80%) participants watched the DVD and completed the interview. The process evaluation assessed whether (1) the DVD content was helpful, (2) any new information was learned by participants, (3) the appropriate amount of information was included in the DVD, (4) participants were engaged when watching the DVD, (5) the DVD content was relevant, (6) participants were satisfied with the DVD (7) participants would recommend the DVD to others, and (8) their opinion about colorectal cancer screening was changed by watching the DVD. Among participants who watched the DVD, 99% reported the screening information was very or somewhat helpful, 47% learned new information, 75% said the DVD included the right amount of information, they were engaged (M = 3.35 out of 4, SD = 0.49), 87% reported all or most information applied to them, they were satisfied (M = 3.42 out of 4, SD = 0.39) with DVD content, 99% would recommend the DVD to others, and 45% reported changing their opinion about screening. To understand the effects of interventions being tested in trials and to plan the dissemination of evidence-based interventions, process evaluation is critical to assess the dose received and acceptability of behavioral interventions.

Development and Feasibility Testing of a Multilevel Intervention to Increase Hepatitis C Virus Screening Among Baby Boomers in Primary Care

“…Following the interviews, patients and providers completed a brief (5-min) quantitative survey. The surveys were distinct for the two groups, but both used previously validated scales where possible and assessed feasibility [ 15 – 18 ], acceptability [ 15 – 17 ], usability [ 15 , 17 , 18 ], user-friendliness [ 17 , 18 ], credibility [ 17 , 18 ], comprehensibility [ 17 , 18 ], and readability [ 16 – 18 ]. Following completion of the survey, participants were redirected to a separate survey to enter their information to receive a gift card.…”

Video brochures in a mailed fecal immunochemical test outreach program provide cancer screening information in a user‐friendly format for rural Appalachian community members

“…Second, the video brochure demonstrated step‐by‐step instructions and presented culturally appropriate content which may be especially useful for rural populations and individuals with low education and limited health literacy. And finally, process evaluation of mailed behavioral interventions is crucial to understand the acceptability and satisfaction with the content of interventions to promote cancer screening 33 …”

“…and presented culturally appropriate content which may be especially useful for rural populations and individuals with low education and limited health literacy. And finally, process evaluation of mailed behavioral interventions is crucial to understand the acceptability and satisfaction with the content of interventions to promote cancer screening 33. Study strengths include a focus on unscreened men and women from a rural geographic area with CRC disparities, and input from Appalachian community members and health care providers to develop the intervention materials.…”

Patient Navigation Plus Tailored Digital Video Disc Increases Colorectal Cancer Screening Among Low-Income and Minority Patients Who Did Not Attend a Scheduled Screening Colonoscopy: A Randomized Trial

“…The program concluded with instructions on how to schedule a colonoscopy or request an FIT kit. We conducted a comprehensive process evaluation and reported the development of the DVD, viewership, engagement, participant perceptions of relevance and satisfaction with the DVD [ 60 ]. Engagement was relatively high with 84% of participants having watched the DVD and 99% reporting that the DVD was very or somewhat helpful.…”

“…Future studies should examine the impact of PN alone on CRC screening test completion in this population. Understanding the receipt, uptake, and satisfaction with any intervention is essential to interpreting the results [ 60 , 84 ]. We conducted a process evaluation to assess these factors by interviewing 243 participants randomized to the interventions; only 194 (80%) completed the process evaluation interview and reported viewing the DVD.…”