Baseline Attitudes About Prostate Cancer Screening Moderate the Impact of Decision Aids on Screening Rates.
BACKGROUND
The impact of decision aids on prostate cancer screening outcomes has been inconsistent.


OBJECTIVE
We assessed whether pre-existing attitudes moderated the impact of decision aids on screening.


METHODS
Men aged 45-70 (56.2% Caucasian, 39.9% African-American) were randomly assigned to a print decision aid (N = 630), a web decision aid (N = 631), or usual care (N = 632). Telephone interviews assessed pro/con screening attitudes and screening behaviors at baseline, 1-month and 13-months post-randomization.


RESULTS
Logistic regression analyses revealed significant arm by attitude interactions: Higher baseline cons scores predicted lower screening in the print (OR = 0.60 (95% CI: 0.40, 0.92)) and web (OR = 0.61 (95% CI: 0.40, 0.91)) arms but not in usual care (OR = 1.34 (95% CI: 0.90, 2.00)).


CONCLUSIONS
The decision aids amplified the impact of men's baseline attitudes about limitations of screening: Compared to the usual care arm, men in both decision aid arms were less likely to be screened when they perceived more limitations of screening.
Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
Amy J
AJ
Starosta
George
G
Luta
Catherine A
CA
Tomko
Marc D
MD
Schwartz
Kathryn L
KL
Taylor
D000368:Aged; D003661:Decision Support Techniques; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D011897:Random Allocation