Abstract
BackgroundAfrican American men are at a higher risk of developing and dying from prostate cancer compared to white men. The serum prostate-specific antigen (PSA) screening test has a high risk of false-positive results and overdiagnosis; therefore, it is not routinely recommended. Rather, men are encouraged to make individualized decisions with their medical providers, after being fully informed about its potential benefits, limitations, and risks.ObjectiveThis study aimed to describe the development and pilot testing of an interactive Web-based decision aid (DA; Prostate Cancer Screening Preparation [PCSPrep]) for African American men, designed to promote informed decision making for prostate cancer screening.MethodsFour focus groups (n=33) were conducted to assess men’s reactions to DAs developed in prior studies and gather information to modify the content and format. The pilot test employed a pre-posttest evaluation design. A convenience sample of 41 men aged 45-70 years with no history of prostate cancer was recruited from community settings. Participants completed online surveys before and after using PCSPrep that assessed prostate cancer screening knowledge, decision self-efficacy, decisional conflict, and preparation for decision making.ResultsUse of PCSPrep was associated with a significant increase in prostate cancer knowledge (49% vs 62% correct responses; P<.001), and men also experienced less decisional conflict (24 vs 15 on a scale of 0-100; P=.008). No changes in self-efficacy about decision making or screening preferences were observed. Most men (81%) reported that using PCSPrep prepared them to make informed decisions in partnership with their provider.ConclusionsPCSPrep was an acceptable DA that improved men’s knowledge, reduced decisional conflict, and promoted the perception of being prepared for shared decision making. Further research is needed to test the DA in a larger randomized trial.
Highlights
BackgroundProstate cancer is the most common cancer among men in the United States [1]
A majority of the participants had heard of the prostate-specific antigen (PSA) test and reported that they had undergone PSA screening in the past (85%)
Principal Findings decision aid (DA) have been found to be effective interventions to complement patient/provider engagement in shared decision making (SDM) by providing patients with information needed to assess their options and examine their values as they relate to those options
Summary
BackgroundProstate cancer is the most common (noncutaneous) cancer among men in the United States [1]. Guidelines emphasize the importance of educating men about the potential risks, benefits, and harms of screening and engaging them in a process of shared decision making (SDM) with their providers [4,5,6,7,8]. The serum prostate-specific antigen (PSA) screening test has a high risk of false-positive results and overdiagnosis; it is not routinely recommended. Objective: This study aimed to describe the development and pilot testing of an interactive Web-based decision aid (DA; Prostate Cancer Screening Preparation [PCSPrep]) for African American men, designed to promote informed decision making for prostate cancer screening. Participants completed online surveys before and after using PCSPrep that assessed prostate cancer screening knowledge, decision self-efficacy, decisional conflict, and preparation for decision making. Further research is needed to test the DA in a larger randomized trial
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