Original Articles

Journal of General Internal Medicine

, Volume 18, Issue 10, pp 781-787

First online:

A randomized controlled trial comparing internet and video to facilitate patient education for men considering the prostate specific antigen test

  • Dominick L. FroschAffiliated withthe SDSU/UCSD Joint Doctoral Program in Clinical Psychology, University of Californiathe Department of Family and Preventive Medicine, University of Californiathe Friends Research Institute Email author 
  • , Robert M. KaplanAffiliated withthe Department of Family and Preventive Medicine, University of California
  • , Vincent J. FelittiAffiliated withSouthern California Permanente Medical Group

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BACKGROUND: Little is known about the relative advantages of video versus internet-based decision aids to facilitate shared medical decision making. This study compared internet and video patient education modalities for men considering the prostate specific antigen (PSA) test.

METHODS: Two hundred and twenty-six men, aged 50 years or older, and scheduled to complete a physical examination at an HMO Health Appraisal Clinic were randomly assigned to access a website (N=114) or view a 23-minute videotape in the clinic (N=112) prior to deciding whether they wanted to be screened for prostate cancer.

RESULTS: There were no between-groups differences in participants’ ratings of convenience, effort, or satisfaction following exposure to the decision aid. Participants assigned to the video group were more likely to review the materials than individuals assigned to the internet group (98.2% vs 53.5%). Participants in the video group showed significantly greater increases in PSA knowledge and were more likely to decline the PSA test than individuals assigned to the internet group. However, participants in the internet group who reviewed the entire online presentation showed similar increases in PSA knowledge as video participants. Only 5% of all participants visited other websites to inform themselves about the PSA test.

CONCLUSIONS: Overall, the video was significantly more effective than the Internet in educating participants about benefits and risks of PSA screening.


patient education decision aids prostate specific antigen Internet