Online narratives and peer support for colorectal cancer screening: A pilot randomized trial

Department of Internal Medicine and the University of Texas-Memorial Hermann Center for Healthcare Quality and Safety, University of Texas Medical School at Houston. Electronic address: .
American journal of preventive medicine (Impact Factor: 4.53). 07/2013; 45(1):98-107. DOI: 10.1016/j.amepre.2013.02.024
Source: PubMed


Delivering personal narratives and peer support for CRC screening in an online weight-loss community could be an efficient approach to engaging individuals at increased risk, because obesity is associated with excess colorectal cancer (CRC) mortality and lower screening rates.
Evaluate user engagement and impact of narratives and peer support for promoting CRC screening in an online weight-loss community.
Pilot randomized trial.
Members of an online weight-loss community who were not up-to-date with CRC screening were enrolled in the study in 2011.
Basic and Enhanced groups (n=153 each) both received education. The Enhanced group also received narratives and peer support for CRC screening in online forums.
The main measures were user engagement, psychosocial outcomes, and self-report CRC screening at 6 months. Analyses were conducted with (1) the full sample of participants and (2) a minimum dose sample of those who participated in their assigned intervention to a minimum degree. Analyses were completed in 2012.
Participants were mostly female (92%) with a mean age of 56 years. More than 90% in both groups viewed the educational information. Only 57% in the Enhanced group joined the online team. The Enhanced group had greater improvement in motivation for screening than the Basic group at 1 month (p=0.03). In the full sample, there was no difference in CRC screening at 6 months (Enhanced 19% vs Basic 16%, adjusted OR=1.33, 95% CI=0.73, 2.42). In the minimum dose sample, fecal occult blood testing was higher in the Enhanced (14%) vs Basic (7%) group (adjusted OR=2.49, 95% CI=1.01, 6.17).
Although no between-group differences in CRC screening were seen at 6 months, this study did demonstrate that it is feasible to deploy a narrative and peer support intervention for CRC screening in a randomized trial among members of an online community. However, modifications are needed to improve user engagement.
This study is registered at NCT01411826.

20 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Starting a new online community with a limited number of members who have not self-selected for participation in the community is challenging. The space must appear active to lure visitors to return; when the pool of participants is small, a large fraction must be converted from lurkers to contributors, and contributors must receive responses quickly to encourage continued participation. We report on strategies for overcoming these challenges and our experience implementing them within an online community add-on to an existing Internet-mediated walking program. Concentrated study recruitment increased the effective membership size. Having few conversation spaces rather than many specialized ones, staff seeding of the forums before members were invited to visit, and staff posting of new topics when there were conversation lulls, all helped to make the forums appear active. In retrospect, using even fewer separate spaces and displaying a flat rather than nested reply structure would have made the forums appear even more active. Contests with small prizes around participation in the forums and around meeting walking goals generated a lot of discussion; a contest for first-time posters was especially effective at moving lurkers to post. Staff efforts to elicit participation by asking questions had mixed success. Staff replies to posts that had not received member replies created a feeling of responsiveness despite limited membership.
    Journal of Medical Internet Research 12/2010; 12(4):e72. DOI:10.2196/jmir.1339 · 3.43 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the acceptability of narratives to promote colorectal cancer (CRC) screening among members of an online weight loss community. Members of online weight loss community completed an Internet survey in 2010. Multiple logistic regression models examined demographic and attitudinal correlates of interest in sharing and receiving CRC screening narratives. Participants (n=2386) were 92% female with mean (SD) age 58 (6) years; 68% were up-to-date with CRC screening. Among those who were up-to-date, 39% were interested in sharing their narratives with other members. African-Americans were more likely than other racial groups to be interested in sharing narratives (adjusted OR 2.02, 95% CI 1.14-3.57). Older, married members and those with greater CRC screening worries were less likely to be interested in sharing narratives. Among those not up-to-date, 63% were interested in receiving narratives from online community members, and those with higher perceived salience of CRC screening were more likely to be interested in receiving narratives (adjusted OR 1.86, 95% CI 1.31-2.65). Members of this online weight loss community expressed interest in sharing and receiving narratives for CRC screening promotion. Attitudes and demographic characteristics may predict successful recruitment of those who would share and receive narratives.
    Preventive Medicine 03/2012; 54(6):405-7. DOI:10.1016/j.ypmed.2012.03.018 · 3.09 Impact Factor
  • American journal of preventive medicine 11/2012; 43(5):571-2. DOI:10.1016/j.amepre.2012.08.001 · 4.53 Impact Factor
Show more