title: Randomized trial examining the effect of two prostate cancer screening educational interventions on patient knowledge, preferences, and behaviors.
abstract: OBJECTIVE
  To assess the effect of video and pamphlet interventions on patient prostate cancer (CaP) screening knowledge, decision-making participation, preferences, and behaviors.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Four midwestern Veterans Affairs medical facilities.
  
  
  METHODS
  One thousand, one hundred fifty-two male veterans age 50 and older with primary care appointments at participating facilities were randomized and 893 completed follow-up.
  
  
  METHODS
  Patients were randomized to mailed pamphlet, mailed video, or usual care/control.
  
  
  RESULTS
  Outcomes assessed by phone survey 2 weeks postintervention included a 10-item knowledge index; correct responses to questions on CaP natural history, treatment efficacy, the prostate-specific antigen (PSA)'s predictive value, and expert disagreement about the PSA; whether screening was discussed with provider; screening preferences; and PSA testing rates. Mean knowledge index scores were higher for video (7.44; P = .001) and pamphlet (7.26; P = .03) subjects versus controls (6.90). Video and pamphlet subjects reported significantly higher percentages of correct responses relative to controls to questions on CaP natural history (63%, 63%, and 54%, respectively); treatment efficacy (19%, 20%, and 5%), and expert disagreement (28%, 19%, and 8%), but not PSA accuracy (28%, 22%, and 22%). Pamphlet subjects were more likely than controls to discuss screening with their provider (41% vs 32%; P = .03) but video subjects were not (35%; P = .33). Video and pamphlet subjects were less likely to intend to have a PSA, relative to controls (63%, 65%, and 74%, respectively). PSA testing rates did not differ significantly across groups.
  
  
  CONCLUSIONS
  Mailed interventions enhance patient knowledge and self-reported participation in decision making, and alter screening preferences. The pamphlet and video interventions evaluated are comparable in effectiveness. The lower-cost pamphlet approach is an attractive option for clinics with limited resources.
authors.affiliation: Center for Chronic Disease Outcomes Research, School of Public Health, University of Minnesota, Minneapolis 55417, USA. Melissa.partin@med.va.gov
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Partin
authors.forename: David
authors.initials: D
authors.lastname: Nelson
authors.forename: David
authors.initials: D
authors.lastname: Radosevich
authors.forename: Sean
authors.initials: S
authors.lastname: Nugent
authors.forename: Ann B
authors.initials: AB
authors.lastname: Flood
authors.forename: Nancy
authors.initials: N
authors.lastname: Dillon
authors.forename: Jeremy
authors.initials: J
authors.lastname: Holtzman
authors.forename: Michele
authors.initials: M
authors.lastname: Haas
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wilt
mesh_terms: D000368:Aged; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D017060:Patient Satisfaction; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D014741:Video Recording
chemical_list: D017430:Prostate-Specific Antigen