Addressing barriers: randomized trial of effect of video education on colonoscopy preparation in Cantonese/Mandarin-speaking patients

<h2>Abstract</h2><h3>Background and Aims</h3> Asian Americans demonstrate lower colonoscopy screening rates than the general U.S. population, highlighting complex cultural and social barriers. We aim to compare the effect of a video-based instructional tool versus standard of care on bowel preparation quality and patient-related factors. <h3>Methods</h3> A randomized controlled trial enrolled Cantonese/Mandarin-speaking patients who underwent outpatient colonoscopies between July and November 2023. Participants (n = 132) were randomly assigned to 2 groups: 1 receiving standard preparation guidance and the other a link to a video educational tool. Primary outcome was Boston Bowel Preparation Scale (BBPS) with secondary outcomes including total procedure time, withdrawal time, patients' anxiety levels, and self-perception of preparation quality. <h3>Results</h3> Of 169 participants enrolled (81 video, 88 control), 31 were excluded because of cancellations, no-shows, or consent withdrawal, resulting in 66 per group. Eleven video group participants did not watch the video and were reassigned to the control group per protocol. Final analysis included 77 in the control group and 55 in the video group, with a 55.5% male composition, averaging 60 years. In the per-protocol analysis, the median BBPS was the same in both groups (<i>P</i> = .064). The mean (95% confidence interval) withdrawal times exhibited no significant difference (<i>P</i> = .74), with averages of 14.4 (12.2-16.7) and 14.8 (12.9-16.9) minutes for the control and video groups, respectively. However, there was a significant difference in patient perception of preparation quality (<i>P</i> = .05), with averages of 9 (8.1-9) and 9.5 (9.3-9.7) for the control and experimental groups, respectively. <h3>Conclusions</h3> Our study suggests that a video-based instructional tool improves Cantonese/Mandarin-speaking participants' perception of colonoscopy preparation quality. There was a trend toward improved BBPS in patients who watched the video, while total procedure and withdrawal times were comparable in both groups. Further research is needed to assess the impact of educational videos and other tools on bowel preparation in this patient population.