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Updated: Jun 10, 2026

E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Effectiveness of a multimedia-based educational intervention for improving colon cancer literacy in screening
James P Hassinger1, Stefan D Holubar, Rajesh Pendlimari
1Mayo Medical School, Mayo Clinic Rochester, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Purpose:
Limited data exist regarding colon cancer literacy in screening colonoscopy patients. We aimed to prospectively assess baseline colon cancer literacy and to determine whether a multimedia educational intervention was associated with improved colon cancer literacy.
Methods:
Colon cancer literacy was assessed in a convenience sample of colonoscopy patients before and after educational intervention. Statistically significant associations with colon cancer literacy scores were assessed by use of multivariate logistic regression analysis. Results are frequency (proportion), mean +/- SD, and odds ratio (OR (95% CI)).
Results:
Seventy-three subjects participated: mean age, 57 +/- 12 years, 35 (48%) were women, 41 (57%) had a college degree, 43 (59%) had prior colonoscopy, 21 (29%) were accompanying family, and 16 (22%) were health care employees. Multivariate factors associated with a higher baseline colon cancer literacy score included health care employee status (7.9 (95% CI, 1.6-63); P = .02) and family colon cancer history (5.3 (95% CI, 1.3-25); P = .02). After multimedia education, mean scores improved from 53% +/- 23% to 88% +/- 12% (Delta = 35%; P < .0001). On univariate analysis, college-educated subjects had higher final scores (91% vs 83%; P = .007), but this association was not significant on multivariate regression (P = .07). Only baseline score was associated with higher postintervention score (1.7 (95% CI, 1.2-2.6); P = .005). Sixty-two subjects (86%) were very satisfied, and 70 (97%) would recommend the module to friends and family.
Conclusion:
A knowledge deficit of colon cancer-related concepts is frequently observed in patients undergoing screening colonoscopy. Multimedia-based educational intervention was an effective, satisfying strategy for addressing cancer-specific knowledge deficit in laypersons.
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