PhD Lilisbeth Perestelo-Perez1,2, MPsych Jeanette Perez-Ramos3, Ms Analia Abt-Sacks2,3, BA Dacil Carballo3, PhD Begoña Bellas4, PhD Nerea Gonzalez2,5, PhD Andrea Buron2,6, MPsych Fatima Izquierdo2, PhD Michael Pignone7, PhD Enrique Quintero4

1 Evaluation Unit of the Canary Islands Health Service, Tenerife, Spain; 2 Health Services Research on Chronic Patients Network (REDISSEC). Tenerife, Spain; 3 Canarian Foundation of Health and Research (FUNCIS), Tenerife, Spain; 4 University Hospital of the Canary Island, Tenerife, Spain; 5 Research Unit, Hospital Galdakao-Usansolo, Galdakao, Spain; 6 Department of Epidemiology and Evaluation, IMIM-Hospital del Mar, Barcelona, Spain; 7 University of North Carolina, Chapel Hill, NC, USA

INTRODUCTION

In Europe, colorectal cancer (CRC) is the most common malignant tumor when taking into account both sexes, and is the second leading cause of cancer death. However, due to existing screening tests, the CCR is one of the few cancers with the possibility of early detection, which significantly increases the chance of cure. One of the main problems with any screening program is to ensure that the target population participate in it, and ensure their cost-effectiveness. Strategies that promote and encourage such participation are needed.

AIMS METHOD ACTUAL STATE

To identify factors (modifiable and non-modifiable) that predict and influence the intention and participation in CRC screening (P,HP,HCS)

YEAR 1

Systematic review (SR)

SR completed. The articles have been classified into: 1) factors; 2) SDM; 3) risk communication. Currently we are performing the data extraction of SR and RCT.

To explore: a) level of knowledge, beliefs, and attitudes about the CRC; and its influence on the decision to participate in a CRC screening program (P); b) attitudes in relation to the SDM model for addressing the CCR (screening, diagnosis / treatment, follow-up) (P,HP)

YEAR 2

Observational cross-sectional national study: interviews, questionnaires, and focus groups.

Year 2015: focus groups with patients and professionals.

To identify: a) barriers and facilitators to the implementation of CRC screening, and to SDM (P,HP): b) strategies to promote SDM, population's desire to participate in decisions about their health (P,HP)

To develop a Web Platform (www.pydesalud.com) that will integrate:

A. Experiences, values, and preferences of people who have participated in a CRC screening program (negative result, positive result without cancer, and CRC).

B. Research needs from the perspective of patients and families.

C.A patient decision aid (PtDA) about CRC screening.

YEARS 2 – 3

•Household interviews videotaped to show users fragments from the experiences of people who have participated in CRC screening programs. Delphi to identify research needs from the perspective of patients, compared with those identified by an expert panel.

A, B): coming.

C) It is collecting information about the disease, treatments, symptoms, prevention, etc. + Developing the technical structure.

To evaluate the acceptability and effectiveness of the PtDA.YEAR 3

Multicenter RCT (pilot study) to compare the effectiveness of PtDA vs. usual care.

Coming.

Perspective: Population (P); Health professionals (HP); Health care system (HCS) / SDM: Shared decision making/ RCT: randomized controlled trials

EXPECTED RESULTS The level of knowledge, beliefs and attitudes of the population about CRC screening influences and predicts the level of participation. Patients and professionals have different attitudes toward shared decision making (SDM) in addressing the screening. The preferences and wishes to participate in the process of SDM in addressing the CCR vary considerably between patients. Patients who receive information through a decision aid on CRC screening, participate more actively in the decision making process. Active involvement of patients and their families in exploring research needs, providing their views and concerns, may lead a more relevant research in

CRC screening. Developing a Web Platform that integrates the best available scientific evidence on CRC screening, as well as integrating the perspective of patients in

relation to CRC, will promote the participation on SDM.

PARTICIPATION OF THE POPULATION IN DECISIONS ABOUT THEIR HEALTH AND IN THE PROCESS OF SHARED DECISION MAKING IN THE COLORECTAL CANCER SCREENING

33 interviews

49 questionnaires

8 Spanish autonomous community

(including pilot study)

Target population• 34 people• Interviews: 10• Focus groups: 24• 50-69 years

Professionals32 people

4 focus groups