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Updated: Jul 2, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Interactive, culturally sensitive education on colorectal cancer screening
Usha Menon1, Laura A Szalacha, Rhonda Belue
1University of Illinois at Chicago, Chicago, Illinois 60625, USA. umenon@uic.edu
Background:
Increasing colorectal cancer screening (CRCS) can have a substantial positive impact on morbidity and mortality.
Objectives:
The purpose of this report is to describe the development and feasibility testing of a computer-based, theory-guided educational program designed to increase CRCS.
Research Design:
This mixed-methods study used focus groups and subsequent randomized controlled trial design.
Subjects:
Participants (N = 199) were randomized to an intervention or control group; 75% were African American; mean age was 57.36 (SD = 6.8); 71% were male.
Measures:
Previously validated measures on knowledge, beliefs, and screening test adherence were used to establish pre- and post-intervention perceptions. Feasibility was measured by response and completion rates, and participants' perceptions of the program.
Results:
Before feasibility testing, the program was presented to 2 focus groups. Changes were made to the program based on discussion, leading to a visually appealing, easy to understand and navigate, self-paced program. In the RCT pilot test that followed, of the participants in the intervention group, 80% said the education helped them decide to get CRCS; 49% agreed it helped them overcome barriers; 91% agreed it was useful, 68% thought it raised new concerns about cancer, but only 30% said it made them worry about CRC; 95% agreed their doctor's office should continue giving such education, and 99% said they would inform family about the program.
Conclusions:
The response rate of 83% demonstrated feasibility of conducting colorectal cancer education in the primary care setting; overall the program was well received; participants averaged 23 minutes to complete it. Participants sought no help from attending data collectors and navigated the revised touch screen program with ease. Computer-based education is feasible in primary care clinics.
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