Skip to main content
Log in

Baseline Attitudes About Prostate Cancer Screening Moderate the Impact of Decision Aids on Screening Rates

  • Brief Report
  • Published:
Annals of Behavioral Medicine

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. American Cancer Society. Cancer Facts & Figures 2014. Atlanta, GA: American Cancer Society; 2014. Available at http://www.cancer.org/acs/groups/content/@research/documents/webcontent/acspc-042151.pdf. Accessed June 23, 2014.

  2. Smith RA, Manassaram-Baptiste D, Brooks D, et al. Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2014; 64: 30-51.

    Article  PubMed  Google Scholar 

  3. Justman S. Uninformed consent: mass screening for prostate cancer. Bioethics. 2012; 26: 143-148.

    Article  PubMed  Google Scholar 

  4. Moyer VA. Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2012; 157: 120-134.

    Article  PubMed  Google Scholar 

  5. Diefenbach M, Turner G, Carpenter KM, et al. Cancer and patient-physician communication. J Health Commun. 2009; 14(Suppl 1): 57-65.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Gigerenzer G, Mata J, Frank R. Public knowledge of benefits of breast and prostate cancer screening in Europe. J Natl Cancer Inst. 2009; 101: 1216-1220.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Sheridan SL, Golin C, Bunton A, et al. Shared decision making for prostate cancer screening: The results of a combined analysis of two practice-based randomized controlled trials. BMC Med Inform Decis Mak. 2012; 12: 130.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Lepore SJ, Wolf RL, Basch CE, et al. Informed decision making about prostate cancer testing in predominantly immigrant black men: A randomized controlled trial. Ann Behav Med. 2012; 44: 320-330.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Williams RM, Davis KM, Luta G, et al. Fostering informed decisions: A randomized controlled trial assessing the impact of a decision aid among men registered to undergo mass screening for prostate cancer. Patient Educ Couns. 2013; 91: 329-336.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Stamatiou K, Skolarikos A, Heretis I, et al. Does educational printed material manage to change compliance with prostate cancer screening? World J Urol. 2008; 26: 365-373.

    Article  PubMed  Google Scholar 

  11. Taylor KL, Williams RM, Davis K, et al. Decision making in prostate cancer screening using decision aids vs usual care: A randomized clinical trial. JAMA Intern Med. 2013; 173: 1704-1712.

    PubMed Central  PubMed  Google Scholar 

  12. Dorfman CS, Williams RM, Kassan EC, et al. The development of a web- and a print-based decision aid for prostate cancer screening. BMC Med Inform Decis Mak. 2010; 10: 12.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Tomko C, Davis KM, Luta G, Krist AH, Woolf SH, Taylor KL. A comparison of web-based versus print-based decision aids for prostate cancer screening: Participants' evaluation and utilization. J Gen Intern Med. 2014; Sep 3. [Epub ahead of print]. DOI:10.1007/s11606-014-2994-7.

  14. Consedine NS, Morgenstern AH, Kudadjie-Gyamfi E, Magai C, Neugut AI. Prostate cancer screening behavior in men from seven ethnic groups: The fear factor. Cancer Epidemiol Biomarkers Prev. 2006; 15: 228-237.

    Article  PubMed  Google Scholar 

  15. Gorin MA, Soloway CT, Eldefrawy A, Soloway MS. Factors that influence patient enrollment in active surveillance for low-risk prostate cancer. Urology. 2011; 77: 588-591.

    Article  PubMed  Google Scholar 

  16. McDowell ME, Occhipinti S, Chambers SK. Classifying the reasons men consider to be important in prostate-specific antigen (PSA) testing decisions: Evaluating risks, lay beliefs, and informed decisions. Ann Behav Med. 2013; 46: 322-335.

    Article  PubMed  Google Scholar 

  17. Silberbogen AK, Busby AK, Ulloa EW. Impact of psychological distress on prostate cancer screening in U.S. military veterans. Am J Mens Health. 2013; 8: 399-408.

    Article  PubMed  Google Scholar 

  18. Ross L, Kohler CL, Grimley DM, Green BL, Anderson-Lewis C. Toward a model of prostate cancer information seeking: Identifying salient behavioral and normative beliefs among African American men. Health Educ Behav. 2007; 34: 422-440.

    Article  PubMed  Google Scholar 

  19. Xu J, Dailey RK, Eggly S, Neale AV, Schwartz KL. Men's perspectives on selecting their prostate cancer treatment. J Natl Med Assoc. 2011; 103: 468-478.

    PubMed Central  PubMed  Google Scholar 

  20. O'Connor AM, Bennett CL, Stacey D, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2009; CD001431.

  21. Rakowski W, Andersen MR, Stoddard AM, et al. Confirmatory analysis of opinions regarding the pros and cons of mammography. Health Psychol. 1997; 16: 433-441.

    Article  CAS  PubMed  Google Scholar 

  22. Chan JM, Jou RM, Carroll PR. The relative impact and future burden of prostate cancer in the United States. J Urol. 2004; 172: S13-S16.

    Article  PubMed  Google Scholar 

  23. Rauscher GH, Johnson TP, Cho YI, Walk JA. Accuracy of self-reported cancer-screening histories: A meta-analysis. Cancer Epidemiol Biomarkers Prev. 2008; 17: 748-757.

    Article  PubMed  Google Scholar 

Download references

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.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kathryn L. Taylor PhD.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-015-9692-5

Keywords

Navigation