Introduction: Low socioeconomic position is associated with lower health literacy, higher rates of colorectal cancer (CRC) mortality, and lower participation rates in screening programs. The organized CRC screening program of the Canton of Vaud, Switzerland developed a new electronic tool to facilitate access to the program and orient low-risk participants towards non-invasive, fecal occult blood tests. This qualitative study aimed to evaluate the user experience of the tool for citizens eligible for the Vaud CRC screening program, including some participants with low health literacy.
Methods: Using the “think-aloud technique”, semi-structured interviews were conducted assessing the user experience with the Morville Honeycomb framework: useful, desirable, accessible, credible, findable, usable, valuable. Participants’ health literacy was evaluated using the S-TOHFLA test. Interviews were transcribed and analyzed thematically on the software MAXQDA, with 20% dual independent coding. COREQ norms were followed.
Results: We performed 9 interviews (mean age 61 years, 78% women, 33% with low health literacy). The electronic tool was regarded as credible and desirable, although barriers were identified in the site’s usability and accessibility. The most frequently cited difficulties were navigational issues and text that was complex to understand (medical terms and information on reimbursement). There was confusion surrounding FIT (Fecal Immunochemical Testing) as a means of participating in screening, although accessing a pharmacy or a health professional were successfully identified as entryways to participation. Users appreciated the presence of graphics, which increased the site’s desirability and aided understanding. Users with limited and sufficient health literacy alike deemed the site to be valuable and useful in its informative role, and important as a public health tool.
Conclusion: Through content and software modifications, the collected feedback was directly useful for the website’s development team since the tool was evaluated at a time its development when substantive changes were still possible. The tool needed to be further simplified, which was a challenge given the need for accurate, specific information.