Abstract
Background
The impact of decision aids on prostate cancer screening outcomes has been inconsistent.
Purpose
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.
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Acknowledgments
We are grateful to the participants for contributing their time; to Janet Ohene-Frempong, MA, our plain language consultant, who contributed to the editing of the intervention materials; to the interviewers who conducted telephone assessments: Sara Edmond, Caroline Dorfman, Elisabeth Kassan, David Dawson, William Tuong, Elizabeth Parker, SofiyaPenek, Samantha Barry, Lisa Haisfield, and to Susan Marx for administrative support.
Funding/Support
This work was supported by grants from the National Cancer Institute (R01CA119168-01) and Department of Defense (PCO51100) to Dr. Taylor. In addition, the project was supported by the Lombardi Comprehensive Cancer Center (LCCC) Biostatistics and Bioinformatics Shared Resource and an LCCC Cancer Center Support Grant.
Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards
Authors Starosta, Luta, Tomko, Schwartz, and Taylor declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
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Starosta, A.J., Luta, G., Tomko, C.A. et al. Baseline Attitudes About Prostate Cancer Screening Moderate the Impact of Decision Aids on Screening Rates. ann. behav. med. 49, 762–768 (2015). https://doi.org/10.1007/s12160-015-9692-5
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DOI: https://doi.org/10.1007/s12160-015-9692-5