Randomized trial examining the effect of two prostate cancer screening educational interventions on patient knowledge, preferences, and behaviors.
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.
Partin
Melissa R
MR
Center for Chronic Disease Outcomes Research, School of Public Health, University of Minnesota, Minneapolis 55417, USA. Melissa.partin@med.va.gov
Nelson
David
D
Radosevich
David
D
Nugent
Sean
S
Flood
Ann B
AB
Dillon
Nancy
N
Holtzman
Jeremy
J
Haas
Michele
M
Wilt
Timothy J
TJ
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
D017430:Prostate-Specific Antigen