Strategies for distributing cancer screening decision aids in primary care.
OBJECTIVE
Decision aids (DAs) have been shown to facilitate shared decision making about cancer screening. However, little data exist on optimal strategies for dissemination. Our objective was to compare different decision aid distribution models.


METHODS
Eligible patients received video decision aids for prostate cancer (PSA) or colon cancer screening (CRC) through 4 distribution methods. Outcome measures included DA loans (N), % of eligible patients receiving DA, and patient and provider satisfaction.


RESULTS
Automatically mailing DAs to all age/gender appropriate patients led to near universal receipt by screening-eligible patients, but also led to ineligible patients receiving DAs. Three different elective (non-automatic) strategies led to low rates of receipt. Clinician satisfaction was higher when patients viewed the DA before the visit, and this model facilitated implementation of the screening choice. Regardless of timing or distribution method, patient satisfaction was high.


CONCLUSIONS
An automatic DA distribution method is more effective than relying on individual initiative. Enabling patients to view the DA before the visit is preferred.


CONCLUSIONS
Systematically offering DAs to all eligible patients before their appointments is the ideal strategy, but may be challenging to implement.
Brackett
Charles
C
Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. cdb@hitchcock.org
Kearing
Stephen
S
Cochran
Nan
N
Tosteson
Anna N A
AN
Blair Brooks
W
W
D000368:Aged; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003657:Decision Making; D003661:Decision Support Techniques; D055088:Early Detection of Cancer; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation / Q000379:methods; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D017010:Reminder Systems; D011795:Surveys and Questionnaires; D014741:Video Recording / Q000379:methods