title: Informed decision making before prostate-specific antigen screening: Initial results using the American Cancer Society (ACS) Decision Aid (DA) among medically underserved men.
abstract: The American Cancer Society (ACS) recommends men have the opportunity to make an informed decision about screening for prostate cancer (PCa). The ACS developed a unique decision aid (ACS-DA) for this purpose. However, to date, studies evaluating the efficacy of the ACS-DA are lacking. The authors evaluated the ACS-DA among a cohort of medically underserved men (MUM).
  
  
  
  A multiethnic cohort of MUM (n = 285) was prospectively included between June 2010 and December 2014. The ACS-DA was presented in a group format. Levels of knowledge on PCa were evaluated before and after the presentation. Participants' decisional conflict and thoughts about the presentation also were evaluated. Logistic regression analyses were performed to determine factors associated with having an adequate level of knowledge.
  
  
  
  Before receiving the ACS-DA, 33.1% of participants had adequate knowledge on PCa, and this increased to 77% after the DA (P < .0001). On multivariate analysis, higher education level (odds ratio, 11.19; P = .001) and history of another cancer (odds ratio, 7.45; P = .03) were associated with having adequate knowledge after receiving the DA. Levels of decisional conflict were low and were correlated with levels of knowledge after receiving the DA. The majority of men also rated the presentation as favorable and would recommend the ACS-DA to others.
  
  
  
  Use of the ACS-DA was feasible among MUM and led to increased PCa knowledge. This also correlated with low levels of decisional conflict. The ACS-DA presented to groups of men may serve as a feasible tool for informed decision making in a MUM population. Cancer 2017;123:583-591. © 2016 American Cancer Society.
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.|Department of Urology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Mehmet I
authors.initials: MI
authors.lastname: Gökce
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Frost
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Pamela
authors.initials: P
authors.lastname: Roberson
authors.affiliation: Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Volk
authors.affiliation: Cancer Control Interventions, American Cancer Society, Atlanta, Georgia.
authors.forename: Durado
authors.initials: D
authors.lastname: Brooks
authors.affiliation: Division of Urology, University of Texas Medical School at Houston, Houston, Texas.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Canfield
authors.affiliation: Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Pettaway
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000570:American Cancer Society; D003657:Decision Making; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000453:epidemiology / Q000473:pathology
chemical_list: D017430:Prostate-Specific Antigen
keywords: decision aid; informed decision making; prostate cancer screening; prostate-specific antigen (PSA) screening; racial disparities