Interventions to Improve Decision Making and Reduce Racial and Ethnic Disparities in the Management of Prostate Cancer: A Systematic Review
Ethnic minorities are disproportionately impacted by prostate cancer (PCa) and are at risk for not receiving informed decision making (IDM). We conducted a systematic literature review on interventions to improve: (1) IDM about PCa in screening-eligible minority men, and (2) quality of life (QOL) in minority PCa survivors.
SUBJECT ELIGIBILITY CRITERIA
We identified U.S.-based, English-language articles (1985 – 2010) on interventions to improve PCa IDM and QOL that included 50 % or more minority patients or analyses stratified by race/ethnicity.
STUDY APPRAISAL AND SYNTHESIS METHODS
Articles (n = 19) were evaluated and scored for quality using a Downs and Black (DB) system. Interventions were organized by those enhancing 1) IDM about PCa screening and 2) improving QOL and symptom among PCa survivors. Outcomes were reported by intervention type (educational seminar, printed material, telephone-based, video and web-based).
Fourteen studies evaluated interventions for enhancing IDM about PCa screening and five evaluated programs to improve outcomes for PCa survivors. Knowledge scores were statistically significantly increased in 12 of 13 screening studies that measured knowledge, with ranges of effect varying across intervention types: educational programs (13 % – 48 % increase), print (11 % – 18 %), videotape/DVD (16 %), and web-based (7 % – 20 %). In the final screening study, an intervention to improve decision-making about screening increased decisional self-efficacy by 9 %. Five cognitive-behavioral interventions improved QOL among minority men being treated for localized PCa through enhancing problem solving and coping skills.
Weak study designs, small sample sizes, selection biases, and variation in follow-up intervals across studies.
Educational programs were the most effective intervention for improving knowledge among screening-eligible minority men. Cognitive behavioral strategies improved QOL for minority men treated for localized PCa.
Systematic review registration number
- Jemal, A, Siegel, R, Xu, J, Ward, E (2010) Cancer statistics, 2010. CA Cancer J Clin 60: pp. 277-300 CrossRef
- Williams, H, Powell, IJ (2009) Epidemiology, pathology, and genetics of prostate cancer among African Americans compared with other ethnicities. Methods Mol Biol 472: pp. 439-453 CrossRef
- Gwede, CK, McDermott, RJ (2006) Prostate cancer screening decision making under controversy: implications for health promotion practice. Health Promot Pract 7: pp. 134-146 CrossRef
- Minardi, D, Galosi, AB, Recchioni, A, Giammarco, L, Polito, M, Muzzonigro, G (2001) Diagnostic accuracy of percent free prostate-specific antigen in prostatic pathology and its usefulness in monitoring prostatic cancer patients. Urol Int 67: pp. 272-282 CrossRef
- Eschenbach, A, Ho, R, Murphy, G, Cunningham, M, Lins, N (1997) American Cancer Society Guideline for the Early Detection of Prostate Cancer: Update 1997. CA Cancer J Clin 47: pp. 261-264 CrossRef
- U.S. Preventive Services Task Force. Screening for Prostate Cancer: US Preventitive Services Task Force Recommendation Statement (DRAFT). 2011. http://www.uspreventiveservicestaskforce.org/uspstf12/prostate/draftrecprostate.htm. Accessed on April 02, 2012.
- Guide to Clinical Preventive Services. United States Preventive Services Task Force. Alexandria, VA: International Medical Publishing; 2nd ed. 1996:119–34.
- Klabunde, CN, Potosky, AL, Harlan, LC, Kramer, BS (1998) Trends and black/white differences in treatment for nonmetastatic prostate cancer. Med Care 36: pp. 1337-1348 CrossRef
- Chan, E, McFall, S, Byrd, T (2011) A community-based intervention to promote informed decision making for prostate cancer screening among Hispanic American men changed knowledge and role preferences: a cluster RCT. Patient Educ Couns 84: pp. 44-51 CrossRef
- Barry, MJ (2009) Screening for prostate cancer–the controversy that refuses to die. N Engl J Med 360: pp. 1351-1354 CrossRef
- Chu K, Tarone R, Freeman H. Trends in prostate cancer mortality among black men and white men in the United States. Cancer. 2003;97(6).
- Demark-Wahnefried, W, Schildkraut, JM, Iselin, CE (1998) Treatment options, selection, and satisfaction among African American and white men with prostate carcinoma in North Carolina. Cancer 83: pp. 320-330 CrossRef
- Dimah, K (2003) Prostate cancer among African American men: a review of empirical literature. J Afr Am Stud 7: pp. 28-46
- Tillman, LC (2002) Culturally sensitive research approaches: an African-American perspective. Educ Res 31: pp. 3-12 CrossRef
- Andersen, BL (2002) Behavioral outcomes following psychological interventions for cancer patients. J Consult Clin Psychol 70: pp. 590-610 CrossRef
- Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS med. 2009;6(7):e1000097.
- Downs, SH, Black, N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 52: pp. 377 CrossRef
- Kripalani, S, Sharma, J, Justice, E (2007) Low-literacy interventions to promote discussion of prostate Cancer: a randomized controlled trial. Am J Prev Med 33: pp. 83-90 CrossRef
- Barber, K, Shaw, R, Folts, M (1998) Differences between African American and Caucasian men participating in a community-based prostate cancer screening program. J Community Health 23: pp. 441-451 CrossRef
- Boehm, S, Coleman-Burns, P, Schlenk, E, Funnell, M, Parzuchowski, J, Powell, I (1995) Prostate cancer in African American men: increasing knowledge and self-efficacy. J Community Health Nurs 12: pp. 161-169 CrossRef
- Carter, VL, Tippett, F, Anderson, DL, Tameru, B (2010) Increasing prostate cancer screening among African American men. J Health Care for Poor Underserved 21: pp. 91-106 CrossRef
- Collins M. Increasing prostate cancer awareness in African American men. Oncol Nurs Forum. 1997;24(1):91.
- Drake, B, Shelton, R, Gilligan, T, Allen, J (2010) A church-based intervention to promote informed decision making for prostate cancer screening among African American men. J Natl Med Assoc 102: pp. 164-171
- Ellison, G, Weinrich, S, Lou, M, Hongyan, X, Powell, I, Baquet, C (2008) A randomized trial comparing web-based decision aids on prostate cancer knowledge for African-American men. J Natl Med Assoc 100: pp. 1139-1145
- Holt, C, Wynn, T, Litaker, M, Southward, P, Jeames, S, Schulz, E (2009) A comparison of a spiritually based and non-spiritually based educational intervention for informed decision making for prostate cancer screening among church-attending African-American men. Urol Nurs 29: pp. 249
- Powell, I, Heilbrun, L, Littrup, P (1997) Outcome of African American men screened for prostate cancer: The Detroit Education and Early Detection Study. J Urol 158: pp. 146-149 CrossRef
- Stephens, RL, Xu, Y, Volk, RJ (2008) Influence of a patient decision aid on decisional conflict related to PSA testing: A structural equation model. Health Psychol 27: pp. 711-721 CrossRef
- Taylor, K, Davis, J, Turner, R (2006) Educating African American men about the prostate cancer screening dilemma: a randomized intervention. Cancer Epidemiol Biomarkers Prev 15: pp. 2179 CrossRef
- Weston, R, Weston, P, Futterman, R (2007) Effectiveness of a modified computer assisted instructional tool in the dissemination of prostate cancer information to men of African descent through black churches. J Afr Am Stud 11: pp. 140-156 CrossRef
- Wilkinson, S, List, M, Sinner, M, Dai, L, Chodak, G (2003) Educating African-American men about prostate cancer: impact on awareness and knowledge. Urology 61: pp. 308-313 CrossRef
- Husaini, B, Reece, M, Emerson, J, Scales, S, Hull, P, Levine, R (2008) A church-based program on prostate cancer screening for African American men: reducing health disparities. Ethn Dis 18: pp. 179-184
- Powell, I, Gelfand, D, Parzuchowski, J, Heilbrun, L, Franklin, A (1995) A successful recruitment process of African American men for early detection of prostate cancer. Cancer 75: pp. 1880-1884 CrossRef
- Penedo, F, Dahn, J, Molton, I (2004) Cognitive behavioral stress management improves stress management skills and quality of life in men recovering from treatment of prostate carcinoma. Cancer 100: pp. 192-200 CrossRef
- Penedo, F, Traeger, L, Dahn, J (2007) Cognitive behavioral stress management intervention improves quality of life in Spanish monolingual Hispanic men treated for localized prostate cancer: results of a randomized controlled trial. Int J Behav Med 14: pp. 164-172 CrossRef
- Campbell, L, Keefe, F, Scipio, C (2007) Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners. Cancer 109: pp. 414-424 CrossRef
- Antoni, MH (2003) Stress management effects on psychological, endocrinological, and immune functioning in men with HIV infection: empirical support for a psychoneuroimmunological model.. Stress: Int J Biol Stress 6: pp. 173-188 CrossRef
- Mishel, M, Belyea, M, Germino, B (2002) Helping patients with localized prostate carcinoma manage uncertainty and treatment side effects. Cancer 94: pp. 1854-1866 CrossRef
- Mishel, M, Germino, B, Lin, L (2009) Managing uncertainty about treatment decision making in early stage prostate cancer: a randomized clinical trial. Patient Educ Couns 77: pp. 349-359 CrossRef
- Partin, MR, Nelson, D, Radosevich, D (2004) Randomized trial examining the effect of two prostate cancer screening educational interventions on patient knowledge, preferences, and behaviors. J Gen Intern Med 19: pp. 835-842 CrossRef
- Volk, RJ, Hawley, ST, Kneuper, S (2007) Trials of decision aids for prostate cancer screening: a systematic review. Am j prev med 33: pp. 428-434 CrossRef
- Evans R, Joseph-Williams N, Edwards A, et al. Supporting informed decision making for prostate specific antigen (PSA) testing on the web: an online randomized controlled trial. J Med Internet Res. 2010;12(3).
- Handley, MR, Stuart, ME (1994) The use of prostate specific antigen for prostate cancer screening: a managed care perspective. J Urol 152: pp. 1689
- Eton, DT, Lepore, SJ (2002) Prostate cancer and health‐related quality of life: a review of the literature. Psycho‐Oncol 11: pp. 307-326 CrossRef
- Penedo, FJ, Dahn, JR, Shen, BJ, Schneiderman, N, Antoni, MH (2006) Ethnicity and determinants of quality of life after prostate cancer treatment. Urology 67: pp. 1022-1027 CrossRef
- Litwin, MS, Flanders, SC, Pasta, DJ, Stoddard, ML, Lubeck, DP, Henning, JM (1999) Sexual function and bother after radical prostatectomy or radiation for prostate cancer: multivariate quality-of-life analysis from CAPSURE. Urology 54: pp. 503-508 CrossRef
- Melmed, GY, Kwan, L, Reid, K, Litwin, MS (2002) Quality of life at the end of life: trends in patients with metastatic prostate cancer. Urology 59: pp. 103-109 CrossRef
- Lepore, SJ, Helgeson, VS, Eton, DT, Schulz, R (2003) Improving quality of life in men with prostate cancer: a randomized controlled trial of group education interventions. Health Psychol 22: pp. 443 CrossRef
- Kon, AA (2010) The shared decision-making continuum. JAMA: J Am Med Assoc 304: pp. 903-904 CrossRef
- Sajid, S, Mohile, SG, Szmulewitz, R, Posadas, E, Dale, W (2011) Individualized decision-making for older men with prostate cancer: balancing cancer control with treatment consequences across the clinical spectrum. Semin Oncol 38: pp. 309-325 CrossRef
- Interventions to Improve Decision Making and Reduce Racial and Ethnic Disparities in the Management of Prostate Cancer: A Systematic Review
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Journal of General Internal Medicine
Volume 27, Issue 8 , pp 1068-1078
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- prostate cancer
- informed decision making
- African American
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- Author Affiliations
- 1. Department of Medicine, Section of Geriatrics & Palliative Medicine, University of Chicago Medical Center, 5841 S. Maryland Avenue, MC6098, Chicago, IL, 60637, USA
- 2. Department of Medicine, Section of Hematology/Oncology, University of Chicago, Chicago, USA