Table 4.

Colorectal cancer screening: study characteristics and results of colorectal cancer screening including colonoscopy and fecal occult blood test/fecal immunochemical test (n = 10)

Author (year), country	Population N (intervention group, control group) Age range	Intervention group description	Results: screening completion
Denizard-Thompson et al. (2020), USA	African American unemployed or annual income <$20 000, limited health literacy Intervention group: n = 223 Control group: n = 227 Age. 50–74	iPad patient decision aid called Mobile Patient Technology for Health-CRC (mPATH-CRC) colorectal cancer. Interventions administered to patients prior to healthcare visit to provide ‘just in time’ info that they could discuss with their provider. 3 primary components: brief decision aid about CRC screening reviewing FOBT and colonoscopy; patient self-ordering of screening tests which triggered the research assistant to enter a co-signature required order under the primary care provider’s name in the ERH; follow-up text or email messages to promote screening test completion.	Receipt of CRC screening Follow-up: 24 weeks Intervention group: 30% vs control group: 15%, P < 0.001 OR = 2.7, CI = 1.7–4.4, P < 0.001
Gabel et al., 2020, Denmark	Low education Intervention group: n = 830 Control group: n = 849 Age: 53–74	Self-administered web-based 16-step decision aid to citizens in the intervention group provided via a link in a separate digital mail, a few days after receiving the standard screening reminder. Decision aid was developed for lower educational attainment citizens. Steps included presented benefits and harms to both options along with basic information about CRC (incidence, mortality, development, symptoms, treatment, etc) and CRC screening (effectiveness, FIT-test, colonoscopy). In each step pop-ups with more details and text were available. Most pop-ups had ‘read more’ functions. By using figures and charts as well as values clarification questions, the decision aid encouraged citizens to consider the information they had just seen or read. On the last page of the decision aid, the citizens were presented with a ‘choice indicator’, summing up the results of the values clarification questions. Further discussion of the choice with family or a doctor was encouraged.	CRC screening uptake with FIT Follow-up:45 days Intervention group: 34.7% vs control group: 27.1%, P < 0.05
Greiner et al. (2014), USA	42% non-Hispanic African American, 28% non-Hispanic white, 27% Hispanic Intervention group: n = 234 Control group: n = 236 Age 45–70	Info and education on CRC screening. Participants responded to ‘implementations intentions’ planning questions specific to CRC screening. Interactive, multimedia touchscreen computer that used either English or Spanish text with narration through headphones, as well as pictures and video targeted to the race/ ethnicity of the participant.	Self-reported CRC screening Follow-up: 26 weeks Intervention group: 54% vs control group: 42% OR = 1.83, CI = 1.23–2.73, P ≤ 0.01
Fernández et al. (2015), USA	Hispanics on the Texas–Mexico border TIMI intervention group: n = 236 SMPI intervention group: n = 236 Control group: n = 204 Age:50–70+	Tailored interactive multimedia intervention (TIMI) delivered using tablet computers with touch screen. Tailoring elements based on responses to questions about readiness (stage of change) to be screened, pros and cons, self-efficacy, perceived risk, and subjective norms. Intervention efforts focused on individuals in pre-contemplation (no CRCS and no intention), contemplation (no CRCS, but considering getting screened), and preparation (no CRCS and planning to get screened) stages of change. As participants proceeded through the interactive media, they were presented with various questions related to psychosocial factors. On the basis of responses, they were presented with information to address their particular concern or encourage screening based on current stage of readiness. Small Media intervention (SMPI): flipchart and DVD about CRC and CRCS.	Any CRCS uptake 6 months TIMI intervention group:10.2% SMPI intervention group: 13.6% Control group: 10.8% Adjusted P = 0.46 No significant difference between groups
Jerant et al. (2014), USA	Multi-ethnic 49.3% non-Hispanic 27.2%Hispanic/English 23.4%Hispanic/Spanish Intervention group: n = 595 Control group: n = 569 Age: 50–75	Tailored interactive multimedia computer program (IMCP), with a computer algorithm for presenting tailored messages, including a specific CRC screening test recommendation based on expanded health belief model measure response. One module assessed and then provided tailored information to increase knowledge of CRC screening tests, next module aimed to increase knowledge of screening harms and inconveniences. Final module assessed self-efficacy, barriers, readiness, test preference, and screening history, and then provided tailored information to enhance them. The IMCP allowed patients to decide how much information to view. English and Spanish versions were developed.	Record-documented CRC screening over 12 months Intervention group: 23% vs control group: 22% Adjusted difference = 0.5 percentage points, 95% CI, (4.3–5.3). Effects did not differ by ethnicity or language.
Miller et al. (2011), USA	African American 74% Mixed literacy, socially disadvantaged population Intervention group: n = 264 Control group: n = 264 Age 50–74	A CRC web-based screening decision aid, called CHOICE (Communicating Health Options through Interactive Computer Education, version 6.0 W), based on a previously validated videotape decision aid. Includes a short introductory overview of CRC screening including CRC prevalence, the rationale for screening, and a description of common screening tests. Program is designed to be accessible to low-literacy patients by using easy-to-understand audio segments, video clips, graphics, and animations. Allows participants to choose to learn more about a specific test, view comparisons of the tests, or end the program.	CRC screening (any) Follow-up: 24 weeks Intervention group: 19% vs control group: 14%, P = 0.25 OR = 1.7, CI = 0.9–3.2, P = 0.12
Miller et al. (2018), USA	53% Low-income persons (<25 000 dollars) Intervention group: n = 223 Control group: n = 227 Age 50–74	mPATH-CRC: an iPad app that displays a CRC screening decision aid, lets patients order their own screening tests, and sends automated follow-up electronic messages to support patients.	CRC screening (any) Follow-up: 24 weeks Intervention group: 30% vs control group: 15% OR = 2.5, CI = 1.6–4.0 accounting for the stratification factor (clinic)
Rawl et al. (2021), USA	African American Intervention group: n = 335 Control group: n = 358 Age intervention group: 56.8 Age control group: 57.8	A computer-tailored intervention assessing a participant’s perceived risk, benefits and barriers to CRC screening, age, sex, and family history in real time followed by tailored messages to support development of beliefs that would be most aligned with a decision to screen for CRC. The intervention was based on the Health Belief and Transtheoretical Models. Program was fully narrated to accommodate people with low literacy. Example of tailored message: if a person had a close family member with CRC a message would be delivered to inform them that they also have an increased risk of CRC.	Screening completion with stool blood test or colonoscopy Follow-up: 6 months Stool blood test Intervention group: 12.5% vs control group 7.3%, P = 0.02 OR = 1.8, CI = 1.1–3.0, P = 0.018 Colonoscopy Intervention group: 18.5% vs control group 14.0%, P = 0.14 OR = 1.4, CI = 0.9–2.2, P = 0.14 Any test Intervention group: 12.5% vs control group: 7.3%, P = 0.02 OR = 1.6, CI = 1.1–2.4, P = 0.02
So et al. (2022), Hong Kong	South Asian older adults and their younger families 320 dyads Intervention group: n = 160 Control group: n = 160 Age range: 56–75	A multimedia health talk, conveying the importance CRC screening and support from younger family members in encouraging their older relatives to undergo screening. Instructor-led health talk with powerpoint presentation + health info booklets (Urdu, Nepali, and Punjabi language) + video clip. Materials culturally and linguistically relevant. Topics: general info about CRC; risk factors, signs, and symptoms; common myths and misconceptions on CRC and screening; CRC prevention and early detection; FIT procedure; Hong Kong CRC screening programs and providers; procedures to follow if screening returned a positive result. Site coordinators assisted participants in accessing FIT. Dyads included one older adult and one younger family member. Control group: waitlist control group.	CRC screening (FIT) Intervention group: 71.8% vs control group: 6.8%, P ≤ 0.01 While all control participants returned the sample through their younger family members, a significant proportion (62.2%) of the intervention participants returned the sample by themselves.
Weinberg et al. (2013), USA	Only women, non-adherent to screening Non-white 3.4% Only high school education or less = 34.7% 5 arm study Intervention group 1: n = 170 (high attentional); n = 172 (low attentional) Intervention group 2: n = 174 (high attentional); n = 173 (low attentional) Control group: n = 171 Age 50–94	Intervention group 1: visually appealing webpage and either high- or low-attentional-style information Intervention group 2: print interventions and either high- or low-attentional-style information The educational content was identical: essential info about CRC screening, rationale, description of different screening techniques, benefits, risk and timing, and info on additional resources. High monitoring version was lengthier and contained extensively detailed messages pertaining to CRC risk status. Screening descriptions were more substantial and the benefits of adherence to preventive behaviors emphasized. All messages were positively framed to underline the potential for gain. Low monitoring was briefer, less detailed, and included messages that were negatively framed to highlight the costs to health if recommended behaviors were not pursued Participants were identified as having high or low monitoring attentional styles from their baseline Cognitive Social Information Processing (C-SHIP) score.	CRC screening (FOBT, colonoscopy, Barium enema) Follow-up: 4 and 12 months 4 months Intervention group 1 : 12.2% Intervention group 2 : 12.0% Control group 12.9% P = 0.95 4 months Intervention group 1 : 18.6% vs Intervention group 2 : 22.4% Control group: 23.4% P = 0.32 No difference in the high or low-attentional-styles

CI, confidence interval; COL/FS, colonoscopy or flexible sigmoidoscopy; CRCS, colorectal cancer screening; FIT, fecal immunochemical test; FOBT, fecal occult blood test; ERH, electronic health records; OR, odds ratio: RR, relative risk; SBT, stool blood test; SMPI, small media intervention; TIMI, tailored interactive multimedia intervention.