title: Mediated decision support in prostate cancer screening: a randomized controlled trial of decision counseling.
abstract: OBJECTIVE
  This randomized trial was conducted to assess the impact of a mediated decision support intervention on primary care patient prostate cancer screening knowledge, decisional conflict, informed decision making (IDM), and screening.
  
  
  METHODS
  Before a routine office visit, 313 male patients eligible for prostate cancer screening completed a baseline telephone survey and received a mailed brochure on prostate cancer screening. At the visit, participants were randomized to either an enhanced intervention (EI) or a standard intervention (SI) group. Before meeting with their physician, EI Group men had a nurse-led "decision counseling" session, while SI Group men completed a practice satisfaction survey. An endpoint survey was administered. Survey data, encounter audio-recordings, and chart audit data were used to assess study outcomes.
  
  
  RESULTS
  Knowledge increased in the EI Group (mean difference of +0.8 on a 10-point scale, p=0.001), but decisional conflict did not change (mean difference of -0.02 on a 4-point scale, p=0.620). The EI Group had higher IDM (rate ratio=1.30, p=0.029) and lower screening (odds ratio=0.67, p=0.102).
  
  
  CONCLUSIONS
  Nurse-mediated decision counseling increased participant prostate cancer screening knowledge, and influenced informed decision making and screening.
  
  
  CONCLUSIONS
  Nurses trained in decision counseling can facilitate shared decision making about screening.
authors.affiliation: Thomas Jefferson University, USA. Ronald.Myers@jefferson.edu
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Myers
authors.forename: Constantine
authors.initials: C
authors.lastname: Daskalakis
authors.forename: Elisabeth J S
authors.initials: EJ
authors.lastname: Kunkel
authors.forename: James R
authors.initials: JR
authors.lastname: Cocroft
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Riggio
authors.forename: Mark
authors.initials: M
authors.lastname: Capkin
authors.forename: Clarence H
authors.initials: CH
authors.lastname: Braddock
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D020000:Decision Support Systems, Clinical / Q000295:instrumentation*; D003937:Diagnosis, Differential; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D015999:Multivariate Analysis; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012306:Risk; D018570:Risk Assessment / Q000379:methods; D012944:Social Support; D013637:Tape Recording