title: Online prostate cancer screening decision aid for at-risk men: a randomized trial.
abstract: OBJECTIVE
  This study examines the efficacy of an online screening decision aid (DA) for men with a family history of prostate cancer.
  
  
  METHODS
  Unaffected Australian men (40-79 years) with at least one affected relative completed the first online questionnaire, were randomized to read either the tailored DA (intervention) or nontailored information about prostate cancer screening (control), then completed a questionnaire postreading and 12 months later. The primary outcome was decisional conflict regarding prostate specific antigen (PSA) testing. The impact of the DA on longitudinal outcomes was analyzed by using random intercept mixed effects models. Logistic and linear regressions were used to analyze the impact of the DA on screening behavior and decision regret. Stage of decision-making was tested as a moderator for decisional conflict and decision regret. The frequency of online material access was recorded.
  
  
  RESULTS
  The DA had no effect on decisional conflict, knowledge, inclination toward PSA testing, accuracy of perceived risk, or screening behavior. However, among men considering PSA testing, those who read the DA had lower decision regret compared with men who read the control materials, β = 0.34, p < .001, 95% confidence interval (CI) = [.22, .53].
  
  
  CONCLUSIONS
  This is the first study to our knowledge to evaluate the uptake and efficacy of an online screening DA among men with a family history of prostate cancer. Men who were undecided about screening at baseline benefitted from the DA, experiencing less regret 12 months later. In relation to decisional conflict, the control materials may have operated as a less complex and equally informative DA.
authors.affiliation: Psychosocial Research Group, Prince of Wales Clinical School, UNSW Medicine, University of New South Wales.
authors.forename: Kaaren J
authors.initials: KJ
authors.lastname: Watts
authors.affiliation: Psychosocial Research Group, Prince of Wales Clinical School, UNSW Medicine, University of New South Wales.
authors.forename: Bettina
authors.initials: B
authors.lastname: Meiser
authors.affiliation: School of Women's and Children's Health, UNSW Medicine, University of New South Wales.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Wakefield
authors.affiliation: School of Public Health, University of Sydney.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Barratt
authors.affiliation: School of Public Health, University of Sydney.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Howard
authors.affiliation: Neuroscience Research Australia, University of New South Wales.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Cheah
authors.affiliation: University of Sydney at Westmead Millennium Institute.
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Mann
authors.affiliation: Calvary Health Care Sydney.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Lobb
authors.affiliation: Walter and Eliza Hall Institute of Medical Research.
authors.forename: Clara L
authors.initials: CL
authors.lastname: Gaff
authors.affiliation: Department of Surgery, University of Sydney.
authors.forename: Manish I
authors.initials: MI
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D003220:Conflict, Psychological; D003657:Decision Making; D003661:Decision Support Techniques; D055088:Early Detection of Cancer / Q000379:methods / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires
chemical_list: D017430:Prostate-Specific Antigen