面向弱势筛查邀请者的数字工具支持知情决策的范围综述：基于人群的癌症筛查研究

处于弱势地位的个体通常不愿参与基于人群的癌症筛查。数字工具，如教育视频、叙事或决策辅助工具，在根据个体偏好定制信息需求方面展现出潜力，能够有效覆盖和告知这些邀请者。本综述旨在概述旨在支持弱势筛查邀请者的知情决策的数字工具的设计特点与报道结果。综述按照“范围综述首选报告项目指南”进行。我们检索了PubMed、Scopus/MEDLINE和Web of Science数据库，筛选出那些评估数字工具有效性、关注乳腺癌、宫颈癌或结直肠癌筛查中的覆盖与信息传达的研究。每个纳入研究的内容包括：研究人群、数字工具类型、开发过程、报道的设计特征及效果。最终筛选出13篇全文阅读的文章，研究设计包括随机对照试验（n=5）、前后测设计（n=7）和实验设计（n=1）。识别出六种数字工具类型：决策辅助（n=6）、教育项目（n=3）、叙事视频（n=1）、短信干预（n=1）、动画视频（n=1）和iPad程序（n=1）。在12/13的干预措施中采用了针对特定人群的设计策略，例如避免专业术语和使用语音覆盖功能。关于覆盖和告知目标人群的效果指标包括：知识、态度、筛查意向、自我效能、易感性、信息感知、价值清晰度和筛查采纳。所有数字工具在至少一项效果指标上都显示出显著改善。数字工具的使用有助于覆盖或告知处于弱势地位的筛查邀请者，然而关于工具的开发过程及其对覆盖和告知效果的影响的证据不足。未来的研究可以考虑结合多种数字工具和动画视觉信息，配合口头文字，提升对弱势筛查邀请者的覆盖与告知效果。

Individuals in a vulnerable position are generally less inclined to participate in population-based cancer screening. Digital tools, such as educational videos, narratives or decision aids, show promise in reaching and informing these invitees by tailoring information needs based on their preferences. This review aims to provide an overview of design features and reported outcomes of digital tools intended to support informed decision making among screening invitees in a vulnerable position.The review was conducted according to the Preferred Reporting Items for Scoping Reviews guidelines. We searched PubMed, Scopus/MEDLINE and Web of Science and included studies when the effectiveness of the digital tool was assessed and focussed on reaching and/or informing screening invitees in a vulnerable position for breast, cervical or colorectal cancer screening. For each included study, the study population, type of digital tool, the development process, reported design features and reported effects were extracted.We found 448 articles, and finally 13 were included in this review after reading full text. Study designs included randomised controlled trials (n = 5), pre-post-test design (n = 7) and experimental design (n = 1). Six different types of digital tools were identified: decision aids (n = 6), educational programs (n = 3), narrative video (n = 1), text-messaging intervention (n = 1), animation video (n = 1), and iPad program (n = 1). A population specific design was applied in 12/13 interventions, such as avoiding jargon and using a voice over function. Reported outcomes measures regarding reaching and informing the target population were: knowledge, attitude, screening intention, self-efficacy, susceptibility, feeling informed, values clarity, and screening uptake. All digital tools reported a significant improvement on at least one of the reported outcome measures.The use of digital tools seems to contribute to reach or inform screening invitees in a vulnerable position for cancer screening. However, insufficient evidence was found regarding the development process of the tools and their effects on outcome measures related to reaching and informing the screening invitees in a vulnerable position. Future research may look in to combining multiple digital tools and animated visual information in combination with spoken text to improve reaching and informing screening invitees in a vulnerable position.