Colorectal cancer can be treated to remission when it is detected early. This underscores the importance of screening for colorectal cancer (Miller et al., 2011). There is an increased incentive for screening for colorectal cancer considering that colorectal cancer ranks fourth among the top causes death for non-cutaneous cancers and an even higher second rank when all cancers are considered. Even with these incentives for compliance with screening protocols, Miller et al., (2011) finds that the compliance rates are still low and attributes it to several factors.
These findings that are corroborated by Hernandez, Chowdhury, Fleming & Griffith, (2011) who find that only 52% of the residents in Florida (the state where Miami-Dade, the location of the population of interest is located) above fifty years have reported have received screening procedures for colorectal cancer. The factors that have been attributed to the low compliance rates for screening protocols for colorectal cancer by scholars such as Miller et al., (2011) include a low literacy among the Latin American population.
The synthesis of evidence from the last translation project showed that 56% of the population that was considered by Schroy, Mylvaganam & Davidson (2014) has low health literacy. Daly, Xu & Levy (2014 finds that addressing the low health literacy rates is important to increasing the compliance rates for the screening of colorectal cancer. Garcia et al., (2014) also found a statistically significance positive correlation between increased literacy in colorectal cancer and several factors that relate the perception of the risks, the general attitudes of the study population and an increase in the willingness to register for and undergo screening for colorectal cancer.
The evidence from these researchers indicates the need for education to increase the literacy of the population of interest on colorectal cancer. This is the intervention upon which this paper is based. The use of education to increase the literacy of the population of interest with the aim of increasing the compliance rates of screening for colorectal cancer. With regards to the method of delivery, the synthesis of evidence in the translation project, and more so, the analysis of possible interventions showed the effectiveness of a web-based approach.
The experiment by Miller et al,. (2011) showed that the 52% of the participants who were assigned to the experimental group and hence exposed to education through the web-based approach showed an increase in the readiness to participate in the screening for colorectal cancer. Mitsutake, Shibata, Ishii & Oka (2012) also found a correlation between the use of web-based approaches (eHealth literacy) and increase knowledge on colorectal cancer as well as an increase in the take up of screening for colorectal screening.
The rationale for the web-based intervention upon which this paper is based on the consideration of the background on the importance of colorectal cancer, the synthesis of evidence regarding the factors that lead to the low compliance rates and the empirical evidence on the effectiveness of the web based strategies. The proposal considered in the paper is the use of informatics-based models to provide an online education to the Latin American population in Miami-Dade with the aim of changing their attitudes towards colorectal cancer thereby increasing the compliance rates for the screening of colorectal cancer.
PICOT Elements Necessary for the Proposed Online Intervention
The P in the PICOT elements relates to the population of patient problems. The population considered in this proposal paper is the Latin American patients who are aged between fifty and seventy years and live in Miami-Dade. This population is among the minority groups in the United States. The population of interest is varied in that it is comprised of various subgroups. One of the subgroups that comprise the population of interest is the Spanish-speaking or non-white Hispanics while the other is the English-speaking or the White Hispanics. Studies have been performed on this population to determine the factors that are associated with the trends in colorectal cancer.
Even though the study by Hernandez et al., (2011) did not focus on the compliance with the screening protocols for colorectal cancer, it found a significant correlation between poverty-related factors and the trends in colorectal cancer among the population. Hernandez et al., (2011 also found a statistically significant correlation between race-related factors and the trends in colorectal cancer among the population. Evidenced from the systematic review of findings reported in randomized trials by Enard, Mullen, Kamath, Dixon & Volk, (2016) showed that the successful use of web-based approaches in such a population is achieved by tailoring the messages to the specific audience. This requires a consideration of the social barriers for the minority communities and developing messages that are not only sensitive to these barriers but also weather them to enhance the communication of the intended information.
The ‘I’ in the PICOT elements relates to the intervention to address the patient problem identified. This is the web-based intervention upon which the proposal paper is based. The intervention in this case is the use of web-based models to offer education in order to improve the literacy of colorectal cancer among the Latin American population between fifty and seventy years in Miami-Dade. Evidence from Miller et al,. (2011) and Mitsutake, Shibata, Ishii & Oka (2012) have shown the effectiveness of web-based educational approaches in improving the literacy of colorectal cancer.
The implementation of this intervention can be achieved through the use of mobile applications that host information on colorectal cancer. Evidence from Sanchez, Palacios, Thompson, Martinez & O’Connell (2013) in the study where they screened for knowledge and behavior with regards to colorectal cancer on a similar population showed that the use of the applications could help increase the knowledge on colorectal cancer among the study population. The use of mobile applications exploits the high penetration rate of mobile phones to assess a wide coverage with the information.
The ‘C’ in the PICOT elements relates to the comparison for the proposed intervention. The comparison for the proposed intervention is a retrospective chart audit of the compliance with the screening protocols for colorectal cancer among Latin American patients aged between fifty and seventy years in Miadi-Dade between January and June of 2015. The retrospective study of the compliance with the screening protocols for colorectal cancer on the same population will help compared the effect of the web-based intervention on compliance rates. The comparison with the findings of the retrospective study will help determine whether the increase of knowledge of colorectal cancer among the population of interest through the web-based intervention results in an increased willingness to comply with colorectal cancer screening.
The ‘O’ in the PICOT elements relates to the outcomes of the web-based intervention. It is the desired outcome after the implementation of the intervention on the identified patient problem or the population. The proposed web-based intervention is meant to increase the compliance with the screening practices for the colorectal cancer among the Latin American patients aged between fifty and seventy years in Miadi-Dade.
The mechanism through which the implementation of the web-based intervention will achieve the increase in the compliance with the screening practices for the colorectal cancer among the Latin American patients aged between fifty and seventy years in Miadi-Dade is backed by empirical evidence from studies by from Miller et al, (2011) and Mitsutake, Shibata, Ishii & Oka (2012) among others. The use of web-based models to offer education to the population considered in the paper will increase their literacy on colorectal cancer. Among other elements, it will inform them of the importance of screening to the early detection and treatment of colorectal cancer. It will also help change the attitudes towards increased willingness for compliance with screening protocols (Garcia et al., 2014).
The ‘T’ in PICOT elements is the time in which the desired outcome is to be achieved. The web-based intervention is to be implemented over a period of sixteen weeks. It is during this period that the desired outcome is expected among the Latin American patients aged between fifty and seventy years in Miadi-Dade. The evaluation of the intervention will be done at the end of the sixteen weeks to yield the results that will be compared against the baseline results in the retrospective study over the months of January to June of 2015.
Reflecting on the Proposed Online Interventions
Health information technologies offer an opportunity for the dissemination of information in healthcare. Health information technologies can be applied effectively to increase the literacy of the population on certain health issues of public concern. Colorectal cancer is one of the health issues where increased literacy among the population is desired by public health authorities. The synthesis of evidence in this paper and in the previous translation project has shown the importance of literacy in colorectal in improving the compliance of screening practices.
Health information technologies have provided another avenue through which target populations can be reached with information on colorectal cancer. They offer a different medium that can enable the dissemination of health information in an innovative way. Health information technologies also take advantage of the significance of technology in communication in the contemporary environment. Stevens & Eardley (2016) report that health information technologies have been empirically shown to improve compliance rates of screening for colorectal cancer.
However, Stevens & Eardley (2016) caution and recommend for innovativeness in addressing the barriers that impede the effectiveness of this perspective in increasing health literacy in colorectal cancer. These barriers were also highlighted by Enard et al., (2016). Baker et al., (2014) find that the health information technologies provide comparatively low-cost strategies for improving the compliance with the screening protocols for colorectal cancer. This is evidence that was derived from the empirical study performed by Baker et al., (2014) on a similar population.
Conclusion
The low compliance rates with the screening protocols for colorectal cancer are a big contributor to the high mortality rates resulting from the disease. However, health information technologies provide an avenue through which evidence-based interventions can be implemented to improve the compliance rates. This entails using web-based models to offer education to the populations of interest. The health information technologies offer various benefits that other approaches may not offer. For instance, using web-based models is comparatively cost-effective. Additionally, this approach takes advantage of the significance of technology in communication in the contemporary environment. For instance, the use of mobile applications exploits the increased use of smartphones. The mobile platform also offers increased penetration compared to other approaches. The use of the web-based approaches will help meet the PICOT elements.
References
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