Enhancing Prostate Cancer Screening Literacy Through Shared Decision-Making: Results of a Randomized Trial in a...

Prostate cancer (PCa) awareness is limited among racial and ethnic minority populations compared with the general US population, contributing to delayed diagnosis and increased PCa-specific mortality. We investigated the utility of a novel decision aid (DA) to support patient participation in shared decision-making.

We created a novel DA directed at vulnerable men and surveyed patients attending a primary care clinic in Newark, New Jersey over 8 months. Participants were randomly assigned to DA and non-DA cohorts (2:1), irrespective of prior PSA screening. All patients completed a standardized presurvey. The intervention cohort received the DA. All participants completed the postsurvey within a week; the DA group received additional DA-specific questions. Demographics were compared using chi-squared analysis. DA utility was assessed using multivariate logistic regression.

One hundred patients (DA, N = 69; non-DA, N = 31) were surveyed. No significant differences in age (P = .618), race (P = .380), education (P = .314), or insurance status (P = .934) existed between cohorts. Adjusted regression showed DA recipients were nearly 6 times more likely to strongly agree they "received as much information as [they] wanted" about PSA testing (OR 5.811, 95% CI 1.885-17.909; P = .002), over 4 times more likely to be "happy with the decision to undergo/decline PSA screening" (OR 4.384, 95% CI 1.566-12.278; P = .005), and over 5 times more likely to accept definitive therapy after a hypothetical diagnosis (OR 5.330, 95% CI 1.749-16.246; P = .003).

In an underserved urban community, the novel DA improved informed decision-making and may serve as a validated tool to increase PCa screening knowledge.