Fostering informed decisions: a randomized controlled trial assessing the impact of a decision aid among men registered to undergo mass screening for prostate cancer.
OBJECTIVE
Screening asymptomatic men for prostate cancer is controversial and informed decision making is recommended. Within two prostate cancer screening programs, we evaluated the impact of a print-based decision aid (DA) on decision-making outcomes.


METHODS
Men (N=543) were 54.9 (SD=8.1) years old and 61% were African-American. The 2(booklet type: DA vs. usual care (UC))× 2(delivery mode: Home vs. Clinic) randomized controlled trial assessed decisional and screening outcomes at baseline, 2-months, and 13-months.


RESULTS
Intention-to-treat linear regression analyses using generalized estimating equations revealed that DA participants reported improved knowledge relative to UC (B=.41, p<.05). For decisional conflict, per-protocol analyses revealed a group by time interaction (B=-.69, p<.05), indicating that DA participants were less likely to report decisional conflict at 2-months compared to UC participants (OR=.49, 95% CI: .26-.91, p<.05).


CONCLUSIONS
This is the first randomized trial to evaluate a DA in the context of free mass screening, a challenging setting in which to make an informed decision. The DA was highly utilized by participants, improved knowledge and reduced decisional conflict.


CONCLUSIONS
These results are valuable in understanding ways to improve the decisions of men who seek screening and can be easily implemented within many settings.
Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA.
Randi M
RM
Williams
Kimberly M
KM
Davis
George
G
Luta
Sara N
SN
Edmond
Caroline S
CS
Dorfman
Marc D
MD
Schwartz
John
J
Lynch
Chiledum
C
Ahaghotu
Kathryn L
KL
Taylor
D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D003220:Conflict, Psychological; D003657:Decision Making; D004219:District of Columbia; D055088:Early Detection of Cancer / Q000523:psychology*; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007258:Informed Consent / Q000523:psychology; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D010174:Pamphlets; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012959:Socioeconomic Factors; D013997:Time Factors