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

摘要

Given the extensive utilization of the Internet for health information, web-based health promotion interventions are widely perceived as an effective communication channel. This study was conducted to determine utilization of a web-based intervention intended to improve colorectal cancer screening in a population of women who are at average risk and non-compliant to current screening recommendations. The study was a randomized controlled trial designed to compare the effectiveness of colorectal cancer screening educational materials delivered via the Internet versus a printed format. In three years, 391 women seen for routine obstetrics/gynecology follow-up at two 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 website utilization. Only 24.6% of women logged onto the website. Age was the only variable that differentiated users from non-users (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 utilization of important health communication interventions.