Abstract
Clinical guidelines for prostate cancer screening (PCS) advise physicians to discuss the potential harms and benefits of screening. However, there is a lack of training programs for informed decision-making (IDM), and it is unknown which IDM behaviors physicians have the most difficulty performing. Identifying difficult behaviors can help tailor training programs. In the context of developing a physician-IDM program for PCS, we aimed to describe physicians’ use of nine key IDM behaviors for the PCS discussion and to examine the relation between the behaviors and physician characteristics. A cross-sectional sample of The American Academy of Family Physicians National Research Network completed surveys about their behavior regarding PCS (N = 246; response rate = 58 %). The surveys included nine physician key IDM behaviors for PCS and a single-item question describing their general practice style for PCS. The most common IDM behavior was to invite men to ask questions. The two least common reported behaviors concerned patients uncertain about screening (i.e., arrange follow-up and provide additional information for undecided men). Physicians reported difficulty with these two behaviors regardless whether they reported to discuss or not to discuss PCS with patients. Reported use of key IDM behaviors was associated with a general practice style for PCS and being affiliated with a residency-training program. Physician training programs for IDM should include physician skills to address the needs of patients uncertain about screening. Future research should determine if actual behavior is associated with self-reported behavior for the PCS discussion.
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Contributors
Elizabeth Hess, scientific editor.
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This project was funded in part by grants from the American Academy of Family Physicians Foundation and the Texas Academy of Family Physicians Foundation (#G0602PB). Dr. Linder was supported through a predoctoral fellowship, The University of Texas School of Public Health Cancer Education and Career Development Program, National Cancer Institute/National Institutes of Health (#R25-CA-57712). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Drs. Mullen, Swank, and Volk were supported by a grant from the Centers for Disease Control and Prevention (#U48DP000057-01, Special Interest Proposal 04-023).
Prior Presentations
We presented an earlier version of the key behavior manuscript before all the data was collected as a poster at the annual meeting for the Society of Behavioral Medicine in Seattle, Washington, in 2010.
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Linder, S.K., Kallen, M.A., Mullen, P.D. et al. Physician Behaviors to Promote Informed Decisions for Prostate Cancer Screening: a National Research Network Study. J Canc Educ 29, 345–349 (2014). https://doi.org/10.1007/s13187-014-0613-2
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DOI: https://doi.org/10.1007/s13187-014-0613-2