Preparing African-American men in community primary care practices to decide whether or not to have prostate cancer screening.
BACKGROUND
This study was a randomized trial to test the impact of an informed decision-making intervention on prostate cancer screening use.


METHODS
The study population included 242 African-American men from three primary care practices who were 40-69 years of age and had no history of prostate cancer. Participants completed a baseline survey questionnaire and were randomly assigned either to a Standard Intervention (SI) group (N=121) or an Enhanced Intervention (EI) group (N=121). An informational booklet was mailed to both groups. EI group men were also offered a screening decision education session. Two outcomes were considered: (1) complete screening (i.e., having a digital rectal exam (DRE) and prostate specific antigen (PSA) testing), and (2) complete or partial screening (i.e., having a PSA test with or without DRE). An endpoint chart audit was performed six months after initial intervention contact. The data were analyzed via exact logistic regression.


RESULTS
Overall, screening use was low among study participants. EI group men had a screening frequency two times greater than that of SI group men, but the difference was not statistically significant: 8% vs. 4 % (OR = 1.94) fo rcomplete screening, and 19% vs. 10% (OR = 2.08) for complete or partial screening. Multivariable analyses showed that being in the EI group and primary care practice were significant predictors of complete or partial screening (OR = 3.9 and OR = 5.64, respectively).


CONCLUSIONS
Prostate cancer screening use may be influenced by exposure to decision education and the influence of screening-related primary care practice factors.
Myers
Ronald E
RE
Division of Genetic and Preventive Medicine Thomas Jefferson University, Philadelphia, PA 19107, USA. ron.myers@mail.tju.edu
Daskalakis
Constantine
C
Cocroft
James
J
Kunkel
Elisabeth J S
EJ
Delmoor
Ernestine
E
Liberatore
Matthew
M
Nydick
Robert L
RL
Brown
Earl R
ER
Gay
Roy N
RN
Powell
Thomas
T
Powell
Roberta Lee
RL
D000328:Adult; D001741:Black or African American; D000368:Aged; D016009:Chi-Square Distribution; D003657:Decision Making; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011320:Primary Health Care / Q000379:methods*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D011795:Surveys and Questionnaires
D017430:Prostate-Specific Antigen