Build It, and Will They Come? Unexpected Findings From a Study on a Web-Based Intervention to Improve Colorectal Cancer Screening

Abstract

Given the extensive use of the Internet for health information, Web-based health promotion interventions are widely perceived as an effective communication channel. The authors conducted this study to determine use of a Web-based intervention intended to improve colorectal cancer screening in a population of women who are at average risk and noncompliant to current screening recommendations. The study was a randomized controlled trial designed to compare the effectiveness of colorectal cancer screening educational materials delivered using the Internet versus a printed format. In 3 years, 391 women seen for routine obstetrics/gynecology follow-up at 2 academic centers provided relevant survey information. Of these, 130 were randomized to the Web intervention. Participants received voluntary access to a password-protected, study-specific Web site that provided information about colorectal cancer and colorectal cancer screening options. The main outcome measures were self-reported and actual Web site use. Only 24.6% of women logged onto the Web site. Age was the only variable that differentiated users from nonusers (p = .03). In contrast, 16% of participants self-reported Web use. There was significant discordance between the veracity of actual and self-reported use (p = .004). Among true users, most (81%) logged on once only. These findings raise questions about how to increase use of important health communication interventions.

Acknowledgments

This study was supported by the National Institutes of Health grant R01 CA102695 (15006).

The authors thank the contributions of Fox Chase Cancer Center's Behavioral Research and Population Studies Facilities; Cheryl Rusten and Susan Echtermeyer, Fox Chase's Health Communications and Health Disparities Department; and Joanne Buzaglo, PhD, Research Director, The Wellness Community.

Notes

Note. p = .004.