Table 2 Strategies used to develop, evaluate cancer-related PtDAs for disadvantaged social groups (k = 20)
Study | Eligibility criteria | Conceptual framework (if specified) | PtDA Format | Delivery Mode, setting | Sub-groups targeted in Dev. | Development (k = 17) | Evaluation (k = 14) |
|---|---|---|---|---|---|---|---|
BCa, Genetic Testing | |||||||
Lerman 1997 [40] | Women 18-75y, ≥1 1st-degree relative with BCa and/or ovarian cancer | Behavioral decision-making models | Structured education (45-60 min) + semi-structured counseling (15-30 min) | By nurse or genetic counselor at oncology clinic | BLK | NR | Included PtDA-by- race interaction (no difference) |
BCa, Treatment | |||||||
Jibaja-Weiss 2010 [50] | Women, early stage BCa | ODSF, EDAM | Interactive DVD/CD soap opera episodes, learning modules (43-207 min) [108] | By patient at clinic (with case manager assistance) | LOW-LIT, UNINS, BLK, HSP, SPN | Content developed by research team, expert advisory panel; usability, acceptability, demand tests conducted in subgroups [108]; adapted to SPN language [108] | A priori focus on multi-ethnic, low literacy women; use of low-literacy DCS |
Marcus 2013 [51] | Women, early stage BCa | Social cognitive, self-regulation theories, Health Belief Model | Interactive, multimedia web-based program or CD (>60 min) + NCI print materials | By patient at home via computer or Internet | LOW-LIT | Content guided by formative research with patients and developed by NCI, literacy, patient education experts with 7th grade readability target; usability, acceptability, demand tests conducted; reviewed for cultural appropriateness [51]; features of development sample NR | NR |
Street 1995 [52] | Women, stage I/II BCa | NR | Interactive, multimedia program (30-45 min) vs. brochure (8 pages) | By patient at oncology clinic | LOW-ED | NR | Stratified/analyzed patients by age-education level (found older-less educated patients were less engaged) |
CRC, Screening | |||||||
Miller 2011 [56] | 50–74y, due for CRCS | Transtheoretical model | Interactive web-based program (~10.1 min) | By patient at primary care clinic | LOW-LIT, BLK | Content based on educational video [57] that was guided by subgroup interviews;[109, 110] navigation designed for “low-literacy” subgroup | Stratified/analyzed patients by literacy level (no difference); used REALM tool |
Pignone 2000 [57] | 50–75y, due for CRCS | Transtheoretical model | Educational video (11 min) | By patient at primary care clinic | LOW-ED, FEM, BLK | Content guided by subgroup interviews; assessed out-of-pocket cost concerns | NR |
Ruffin 2007 [58] | 50–70y, due for CRCS | Elaboration likelihood model | Interactive web-based education tool | By patient in community setting via Internet | FEM, BLK | Content and usability testing guided by subgroup FGs and interviews; race-, gender- and insurance-related issues, potential differences were explored [111]. | A priori focus on blacks |
50–75y, due for CRCS | ODSF | Interactive DVD + personal risk assessment tool (20-30 min) | By patient at primary care clinic | LOW-ED, FEM, MCAID, BLK | Content guided by expert opinion, subgroup FGs and assessed out-of-pocket cost concerns, cultural sensitivity issues; usability tests conducted in subgroups | A priori focus on blacks and low-income non-Hispanic whites | |
PCa Screening | |||||||
Chan 2011 [63] | Men ≥40y, no PCa history | ODSF | Script, slides + video clips of role models (90-120 min), short booklets | By promotores to community center groups | LOW-ED, UNINS, MCAID, NONUS, HSP, SPN | Content guided by key informants, FGs; concept mapping conducted with men/spouses; adapted to SPN language | A priori focus on Hispanic and immigrant men |
Lepore 2012 [67] | Men 45-70y, no PCa history | ODSF, social learning theory | Pamphlet + counseling sessions (~26.3 min) | By patient at home + health-educator via phone | LOW-ED, BLK | Content guided by expert opinion; feedback from men in target subgroups (including picture selection); cognitive interviews [112] | A priori focus on black and immigrant men; used low-literacy DCS |
Myers 2005 [68] | Men 40-69y, no PCa or BPH history | PHM, AHP | Booklet + decision counseling session | By patient at home + health-educator via phone | LOW-ED, BLK | Content field-tested by literacy expert in face-to-face interviews with subgroup [113]; decision counseling protocol pilot tested in primary care practices in target community [113] | A priori focus on black men |
Myers 2011 [69] | Men 50-69y, no PCa or BPH history | PHM, AHP | Booklet + decision counseling session | By patient at home + health-educator at primary care clinic | Refer to Myers 2005 [68] | Refer to Myers 2005 [68] | NR |
Sheridan 2012 [73] | Men 40-80y, no PCa history | NR | Video (12 min) + coaching session (8 min) | By patient at primary care clinic (with research assistance) | NONWHT | Content pre-tested in FGs, cognitive interviews, usability tests in subgroups | NR |
Taylor 2013 [74] | Men 45-70y, no PCa history | NR | Interactive web-based tool + booklet (~34 min) | By patients at home | LOW-LIT, BLK | Content guided by expert opinion, key informants, subgroup FGs [114, 115]; adapted to 8th grade readability by plain language expert; usability, acceptability, demand tests conducted in subgroups with limited computer/internet skills [114, 116] | NR |
Volk 2003 [76] | Men 45-70y, no PCa history | NR | Videotape (~20 min) + brochure | By patient at PC clinic | NR | NR | Stratified analysis by race (found difference in screening rates) |
Volk 2008 [77] | Men 40-70y, no PCa history | ODSF, EDAM | Interactive DVD/CD-based soap opera episodes, learning modules (53-68 min) | By patient at public hospital clinic (with research assistance) | LOW-LIT, UNINS, BLK | Content tailored using racial/ethnic concordance, social matching; acceptability tests conducted in subgroups | Stratified analysis by literacy; a priori interest in low-literacy black men (found differences in acceptability, decisional conflict); used low-literacy DCS |
Williams 2013 [78] | Men 40-70y, no PCa history | NR | Booklet | By patient at home vs. patient at cancer screening clinic | LOW-LIT, BLK | Content by expert opinion, key informants, subgroup FGs [114, 115]; adapted to 8th grade readability by plain language expert; usability tests conducted in subgroups [114] | Stratified sub-analyses by race, including race-by delivery mode interaction (no differences) |
Wolf 1996 [79] | Men ≥50y, no PSA testing or PCa history | NR | Script about PSA screening | By research assistant at PC clinic | LOW-ED, NONWHT | Content developed by physician experts; piloted via subgroup interviews; assessed for comprehensibility | Stratified sub-analyses by income, education (no difference) |
PCa Treatment | |||||||
Men, localized PCa | ODSF | Interactive web-based program (~46 min) + usual patient education | Patient at home or oncology clinic | BLK | Content tailored by race via subgroup FGs, interviews [117, 118]; feasibility, acceptability tests conducted | Efficacy evaluation discussed decisional conflict by race (found differences in decisional conflict, perceived decision support) | |
Marcus 2013 [51] | Men, newly diagnosed localized PCa | Social cognitive, self-regulation theories, Health Belief Model | Interactive, multimedia web-based or CD program (>60 min) + NCI print materials | By patient at home via computer/internet | LOW-LIT, BLK | Content guided by formative research with patients and developed by NCI, literacy/patient education experts with 7th grade readability target; usability, acceptability, demand tests conducted; reviewed for cultural appropriateness [51]; features of development sample NR [119] | NR |