Intervention A multimedia patient education program on colorectal cancer screening increases knowledge and willingness to consider screening among Hispanic/Latino patients Gregory Makoul a, *, Kenzie A. Cameron b,c,d , David W. Baker b,c,d , Lee Francis c,e , Denise Scholtens b,f,g , Michael S. Wolf b,c,d,g a Saint Francis Hospital and Medical Center, Hartford, USA b Center for Communication and Healthcare, Northwestern University Feinberg School of Medicine, Chicago, USA c Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA d Institute for Healthcare Studies Northwestern University Feinberg School of Medicine, Chicago, USA e Erie Family Health Center, Chicago, USA f Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, USA g Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, USA 1. Introduction The U.S. Preventive Services Task Force, as well as the American Cancer Society and multiple professional associations, strongly recommend that both men and women age 50 and older be screened for colorectal cancer (CRC), the second leading cause of cancer death among men and women in the United States [1–6]. In 2006 alone, an estimated 148,610 American adults were newly diagnosed with CRC, and approximately 55,170 individuals died due to colorectal cancer [7]. Periodic screening for CRC can reduce cancer-related mortality by detecting and removing precancerous adenomas, preventing later stage presentation of disease [5,7]. Estimates suggest that more than 50% of CRC deaths could be prevented if routine screening occurred among all people of 50 years and older [8]. Recommended CRC screening tests include fecal occult blood test (FOBT), fecal immunochemical test (FIT), flexible sigmoidoscopy, colonoscopy, and double-contrast barium enema [3]. Patient Education and Counseling 76 (2009) 220–226 ARTICLE INFO Article history: Received 20 March 2008 Received in revised form 23 December 2008 Accepted 13 January 2009 Keywords: Colorectal cancer Screening Hispanic/Latino Health promotion Multimedia ABSTRACT Objective: To test a multimedia patient education program on colorectal cancer (CRC) screening that was designed specifically for the Hispanic/Latino community, and developed with input from community members. Methods: A total of 270 Hispanic/Latino adults, age 50–80 years, participated in Spanish for all phases of this pretest–posttest design. Patients were randomly assigned to a version of the multimedia program that opened with either a positive or negative introductory appeal. Structured interviews assessed screening relevant knowledge (anatomy and key terms, screening options, and risk information), past screening behavior, willingness to consider screening options, intention to discuss CRC screening with the doctor, and reactions to the multimedia patient education program. Results: The multimedia program significantly increased knowledge of anatomy and key terms (e.g., polyp), primary screening options (FOBT, flexible sigmoidoscopy, colonoscopy), and risk information as well as willingness to consider screening (p < .001 for all). No significant differences emerged between positive and negative introductory appeals on these measures, intention to discuss CRC screening with their doctor, or rating the multimedia program. Conclusion: Multimedia tools developed with community input that are designed to present important health messages using graphics and audio can reach Hispanic/Latino adults across literacy levels and ethnic backgrounds. Additional research is needed to determine effects on actual screening behavior. Practice implications: Despite promising results for engaging a difficult-to-reach audience, the multimedia program should not be considered a stand-alone intervention or a substitute for communication with physicians. Rather, it is a priming mechanism intended to prepare patients for productive discussions of CRC screening. ß 2009 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT 06105 USA. Tel.: +1 860 714 5071; fax: +1860 714 1517. E-mail address: gmakoul@stfranciscare.org (G. Makoul). Contents lists available at ScienceDirect Patient Education and Counseling journal homepage: www.elsevier.com/locate/pateducou 0738-3991/$ – see front matter ß 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2009.01.006