Smarter Medical Care & Canadian Cancer Society

The Canadian Cancer Society partnered with Smarter Medical Care to design a video specifically for low health literacy individuals, with the goal of making cancer understandable to them. The CCS then commissioned a study to determine the efficacy of the video in accomplishing this goal with the primary audience. Below is a summary of those results as presented at the 2017 International Cancer Patient Education Conference.

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How a 2-Minute Video Can Help Patients Understand Cancer

Objective

Using plain language and simple graphics, help viewers understand what cancer is and how it develops.

Audience

Primary audience: people with low health literacy who need cancer-related information – people with cancer and their caregivers, friends, and family.

Secondary audiences: healthcare providers, patient educators at cancer centers, and staff and volunteers of the Canadian Cancer Society.

Background

Making sure that people with low health literacy have cancer information that they can understand and act on has never been more urgent. The number of new cancer cases in Canada will rise dramatically in the next 15 years. This greater burden on our healthcare system will increase the need for resources about cancer that are easy to access and easy to understand.

The Canadian Cancer Society (CCS) develops and maintains in-depth information on all types of cancer in print and on cancer.ca. We follow the principles of plain language so that a wide audience can understand and use our information. But what about people whose needs are not met by written information? In partnership with Smarter Medical Care, we created a pilot video called What is cancer?

Video is an educational format that is accessible and meets the needs of various learners. If done well, videos can be shared widely and reach diverse audiences in ways that text alone can’t. When information is presented in an engaging way, people are more likely to watch, remember and learn. We conducted qualitative user testing to make sure that the video met its learning objectives.

User Testing

CCS commissioned Matchbox Research to conduct testing.

For the purpose of this study, low literacy is equated with low health literacy. Because it was not practical to assess literacy skills directly or health literacy skills in general, we used education as a proxy indicator. We chose mostly participants with high school only or a lower income level (under $35K), who are not self-employed or students. Non-low literacy individuals (with a college education) were also included for context.

Six 1:1 interviews were conducted in December 2016 – 3 in person and 3 by phone.

Participants were first asked about their knowledge of cancer. Then they watched the video and their understanding of cancer was re-evaluated.

What We Learned From Testing

The video effectively shifts how people answer the question “What is cancer?” Before viewing the video, cancer was not well understood by participants. Though most felt they had an average level of knowledge about what cancer is, they struggled to explain when prompted. Most often, they referenced prognosis first.

Cancer is a disease and there’s no cure. Chemotherapy can reduce it or stop it a for a brief period but it’s still there.

–Cancer Patient

Tumors

Most did not understand the difference between cancerous and non-cancerous tumors before watching the video. After watching the video nearly all were able to explain the difference between cancerous and non-cancerous tumors.

I didn’t think even one iota about tumors before watching the video. Tumours and cancer were separated in my understanding.

Origins

The origin of cancer was not mentioned prior to video exposure. Afterward most mentioned that cancer starts in the cells. Naming convention stuck with the participants, demonstrating the video’s capacity to make medical terminology accessible.

It’s bladder cancer that has metastasized into the lungs. Cancer starts in our cells.

Metastasis

The word “metastasis” stood out for several as a key learning. However, individuals had a hard time pronouncing it.

What was that word? Metas … something. (A key takeaway was) that word metastasize.

Conclusion and Future Directions

A 2-minute video can help you learn about cancer. The learning objectives must be few in number, and the presentation and content must be easy to follow and understand. The short video format will not likely suit all cancer-related topics, but consultation and testing should help assess what is suitable.
The draft pilot video helped us find sponsorship for the Cancer Basics video series, now generously sponsored by BMO. With this funding, we will produce 21 educational videos in total.
The launch of the first video helped us recruit new collaborators and expert reviewers keen to see more videos in this format. Two other videos are currently in production for release in 2017: Coping when you’re first diagnosed with cancer and Taking oral chemotherapy at home.

Note: For the purpose of this study (and this report,) low literacy is equated to low health literacy. Because it was not practical to assess literacy skills directly or health literacy skills in general, education was used as a proxy indicator. Participants with high school only or lower income level (under $35K,) who are not self-employed or students were chosen to represent low-literacy individuals. Non-low literacy individuals were also included (based on college education) for context.

Reach

  • What is cancer? – launched February 28, 2017
  • Newsletters and emails to over 1,200 HCPs
  • Social media promotion: over 36K views and impressions, almost 1,500 engagements
  • cancer.ca + YouTube (first 3 months) over 11K page views+ about 3K views

References

  • Canadian Cancer Statistics 2017. Canadian Cancer Statistics Advisory Committee, Toronto, ON. Canadian Cancer Society 2017.
  • Knowledge Synthesis: Best practices and future trends in cancer information provision. Robyn Sachs and Jennifer Dotchin, for the Canadian Cancer Society. November 2013.
  • Health Literacy: Hidden Barriers and Practical Strategies. Content last reviewed January 2015. Agency for Healthcare Research and Quality, Rockville, MD.
  • Video Test In-Depth Interviews Topline Report. Maru/Matchbox Research for the Canadian Cancer Society. January 2017.

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  • Improve Health Literacy

    Well designed animated videos can significantly increase understanding among all ages, cultures, and health literacy levels.

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