JMIR Publications

ABSTRACT

Background:

While online portals may be helpful to engage patients in shared decision making at the time of cancer screening, a sole reliance on portals could exacerbate well-known disparities in cancer screening. Innovative ways are needed to engage patients in health care decision making and support shared decision making equitably.

Objective:

We assessed the acceptability of text messages to engage socio-demographically diverse individuals in colorectal cancer (CRC) screening decisions and support shared decision making in practice.

Methods:

We developed a brief text message program offering educational information consists of components of shared decision making regarding CRC screening (e.g., for whom screening is recommended/screening test options and pros/cons of options). The program and post-program survey were offered to members of an online panel. The outcome of interest was program acceptability measured by observed program engagement, participant-reported acceptability, and willingness to use similar programs (behavioral intent). We evaluated acceptability among historically marginalized categories of people defined by income, literacy, and race.

Results:

Of the 289 participants, 115 were low-income, 146 were Black/African American, and 102 had less than extreme confidence in literacy. With one exception, we found equal or greater acceptability, regardless of measure, within each of the historically marginalized categories of people compared to their counterparts. The exception was that participants reporting income <$50,000 were less likely to engage with enough of the program to learn there was a choice of different CRC screening tests. Of note, Black/African Americans reported being more likely

Conclusions:

Study findings demonstrate general acceptance of text messages to inform and support CRC screening shared decision making. Clinical Trial: N/A