Background. The efficacy of prostate cancer (CaP) screening with the prostate-specific antigen (PSA) test is debated. Most medical organizations recommend that men make individual, informed decisions about whether to undergo screening. Informed decision making (IDM) requires adequate knowledge about CaP as well as the risks and benefits of screening; confidence in the ability to participate in decision making at a personally desired level (decision self-efficacy); and decision making that reflects one's values and preferences (decisional consistency). Methods. Baseline data from a randomized trial in 12 worksites were analyzed. Men aged 45+ (n = 812) completed surveys documenting screening history, screening preferences and decisions, CaP knowledge, decision selfefficacy, and decisional consistency. Psychosocial and demographic correlates of IDM were also assessed. Results. Approximately half of the sample had a prior PSA test, although only 35% reported having made an explicit screening decision. Across the sample, CaP knowledge was low (mean = 56%), although decision selfefficacy was high (mean = 78%), and the majority of men (81%) made decisions consistent with their stated values. Compared with those who were undecided, men who made an explicit screening decision had significantly higher levels of knowledge, greater decisional self-efficacy, and were more consistent in terms of making a decision in alignment with their values. They tended to be white, have high levels of income and education, and had discussed screening with their health care provider. Conclusions. Many men undergo CaP screening without being fully informed about the decision. These findings support the need for interventions aimed at improving IDM about screening, particularly among men of color, those with lower levels of income and education, and those who have not discussed screening with their provider.
La decisión de someterse a la cirugía bariátrica debe basarse en una información precisa sobre los posibles riesgos y beneficios de todas las opciones de tratamiento. El objetivo de este estudio fue determinar si un vídeo basado en resultados de la intervención bariátrica ayuda a la decisión en la calidad de la toma superior, en comparación con un folleto educativo. Se realizó un estudio prospectivo, aleatorizado controlado en pacientes adultos en un solo plan de salud que cumplían los criterios estándar para la cirugía bariátrica. Los pacientes fueron asignados al azar a revisar ya sea una ayuda basada en video decisión (intervención) o un folleto educativo sobre la cirugía bariátrica (control). Los cambios en la calidad de la decisión del paciente se evaluó a través de medidas-bariátricos específica de conocimiento, los valores y las preferencias de tratamiento después de 3 meses. De los 152 participantes elegibles, 75 fueron asignados al azar a la intervención y 77 al control. La tasa de seguimiento de 3 meses fue del 95%. Entre todos los participantes, se observaron mejoras significativas en el conocimiento (P <0,001), los valores de concordancia (P = 0,009), conflicto de decisiones (P <0,001), la auto-eficacia decisional (P <0,001), y en la proporción que estaban "seguros "de su elección de tratamiento (P <0,001). El grupo de intervención tuvo grandes mejoras en el conocimiento (p = 0,03), conflicto de decisiones (P = 0,03), y las expectativas de resultados (P = 0,001). La proporción de participantes que eligen la cirugía bariátrica no difirió significativamente entre los grupos, aunque hubo una tendencia hacia la disminución de la opción quirúrgica en el grupo de intervención (59% vs 42% folleto de vídeo a los 3 meses, p = 0,16). El uso de la ayuda en la decisión de la cirugía bariátrica fue seguido por una mejor calidad de la decisión y la reducción de la incertidumbre sobre el tratamiento a los 3 meses. La ayuda a la decisión basada en el vídeo parece tener un impacto mayor que el folleto educativo sobre el conocimiento del paciente, conflicto de decisiones, y las expectativas de resultados.
Revista»Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
Background. The efficacy of prostate cancer (CaP) screening with the prostate-specific antigen (PSA) test is debated. Most medical organizations recommend that men make individual, informed decisions about whether to undergo screening. Informed decision making (IDM) requires adequate knowledge about CaP as well as the risks and benefits of screening; confidence in the ability to participate in decision making at a personally desired level (decision self-efficacy); and decision making that reflects one's values and preferences (decisional consistency). Methods. Baseline data from a randomized trial in 12 worksites were analyzed. Men aged 45+ (n = 812) completed surveys documenting screening history, screening preferences and decisions, CaP knowledge, decision selfefficacy, and decisional consistency. Psychosocial and demographic correlates of IDM were also assessed. Results. Approximately half of the sample had a prior PSA test, although only 35% reported having made an explicit screening decision. Across the sample, CaP knowledge was low (mean = 56%), although decision selfefficacy was high (mean = 78%), and the majority of men (81%) made decisions consistent with their stated values. Compared with those who were undecided, men who made an explicit screening decision had significantly higher levels of knowledge, greater decisional self-efficacy, and were more consistent in terms of making a decision in alignment with their values. They tended to be white, have high levels of income and education, and had discussed screening with their health care provider. Conclusions. Many men undergo CaP screening without being fully informed about the decision. These findings support the need for interventions aimed at improving IDM about screening, particularly among men of color, those with lower levels of income and education, and those who have not discussed screening with their provider.
