Racial differences in veterans’ response to a standard vs. patient-centered decision aid for prostate cancer: Implications for decision making in African American and White men

2020 ◽  
Vol 103 (12) ◽  
pp. 2460-2467
Author(s):  
Aisha T. Langford ◽  
Laura D. Scherer ◽  
Peter A. Ubel ◽  
Margaret Holmes-Rovner ◽  
Karen A. Scherr ◽  
...  
2008 ◽  
Vol 3 (4) ◽  
pp. 340-351 ◽  
Author(s):  
Jennifer D. Allen ◽  
Anshu P. Mohllajee ◽  
Rachel C. Shelton ◽  
Bettina F. Drake ◽  
Dana R. Mars

African American men experience a disproportionate burden of prostate cancer (CaP) morbidity and mortality. National screening guidelines advise men to make individualized screening decisions through a process termed informed decision making (IDM). In this pilot study, a computer-tailored decision-aid designed to promote IDM was evaluated using a pre-/posttest design. African American men aged 40 years and older were recruited from a variety of community settings ( n = 108). At pretest, 43% of men reported having made a screening decision; at posttest 47% reported this to be the case ( p = .39). Significant improvements were observed between pre- and posttest on scores of knowledge, decision self-efficacy, and decisional conflict. Men were also more likely to want an active role in decision making after using the tool. These results suggest that use of a computer-tailored decision aid is a promising strategy to promote IDM for CaP screening among African American men.


2010 ◽  
Vol 4 (3) ◽  
pp. 189-206 ◽  
Author(s):  
Gayathri Sridhar ◽  
Saba W. Masho ◽  
Tilahun Adera ◽  
Viswanathan Ramakrishnan ◽  
John D. Roberts

Prostate cancer is the second leading cause of cancer-related mortality in men. This meta-analysis was conducted to investigate the relationship between race and survival from prostate cancer. A systematic review of articles published from 1968 to 2007 assessing survival from prostate cancer was conducted. Analysis of unadjusted studies reported that African American men have an increased risk of all-cause mortality (hazard ratio [HR] = 1.47, 95% confidence interval [CI] = 1.31-1.65, p < .001). However, examination of adjusted studies identified no difference (HR = 1.07, 95% CI = 0.94-1.22, p = .308). No statistically significant difference was observed in prostate cancer—specific survival in both analyses using unadjusted (HR = 1.11, 95% CI = 0.94-1.31, p = .209) and adjusted studies (HR = 1.15, 95% CI = 0.95-1.41, p = .157). This meta-analysis concludes that there are no racial differences in the overall and prostate cancer—specific survival between African American and White men.


10.2196/15502 ◽  
2020 ◽  
Vol 8 (5) ◽  
pp. e15502 ◽  
Author(s):  
Jennifer Dacey Allen ◽  
Amanda Reich ◽  
Adolfo G Cuevas ◽  
Keren Ladin

Background African American men are at a higher risk of developing and dying from prostate cancer compared to white men. The serum prostate-specific antigen (PSA) screening test has a high risk of false-positive results and overdiagnosis; therefore, it is not routinely recommended. Rather, men are encouraged to make individualized decisions with their medical providers, after being fully informed about its potential benefits, limitations, and risks. Objective This study aimed to describe the development and pilot testing of an interactive Web-based decision aid (DA; Prostate Cancer Screening Preparation [PCSPrep]) for African American men, designed to promote informed decision making for prostate cancer screening. Methods Four focus groups (n=33) were conducted to assess men’s reactions to DAs developed in prior studies and gather information to modify the content and format. The pilot test employed a pre-posttest evaluation design. A convenience sample of 41 men aged 45-70 years with no history of prostate cancer was recruited from community settings. Participants completed online surveys before and after using PCSPrep that assessed prostate cancer screening knowledge, decision self-efficacy, decisional conflict, and preparation for decision making. Results Use of PCSPrep was associated with a significant increase in prostate cancer knowledge (49% vs 62% correct responses; P<.001), and men also experienced less decisional conflict (24 vs 15 on a scale of 0-100; P=.008). No changes in self-efficacy about decision making or screening preferences were observed. Most men (81%) reported that using PCSPrep prepared them to make informed decisions in partnership with their provider. Conclusions PCSPrep was an acceptable DA that improved men’s knowledge, reduced decisional conflict, and promoted the perception of being prepared for shared decision making. Further research is needed to test the DA in a larger randomized trial.


2019 ◽  
Author(s):  
Jennifer Dacey Allen ◽  
Amanda Reich ◽  
Adolfo G Cuevas ◽  
Keren Ladin

BACKGROUND African American men are at a higher risk of developing and dying from prostate cancer compared to white men. The serum prostate-specific antigen (PSA) screening test has a high risk of false-positive results and overdiagnosis; therefore, it is not routinely recommended. Rather, men are encouraged to make individualized decisions with their medical providers, after being fully informed about its potential benefits, limitations, and risks. OBJECTIVE This study aimed to describe the development and pilot testing of an interactive Web-based decision aid (DA; Prostate Cancer Screening Preparation [PCSPrep]) for African American men, designed to promote informed decision making for prostate cancer screening. METHODS Four focus groups (n=33) were conducted to assess men’s reactions to DAs developed in prior studies and gather information to modify the content and format. The pilot test employed a pre-posttest evaluation design. A convenience sample of 41 men aged 45-70 years with no history of prostate cancer was recruited from community settings. Participants completed online surveys before and after using PCSPrep that assessed prostate cancer screening knowledge, decision self-efficacy, decisional conflict, and preparation for decision making. RESULTS Use of PCSPrep was associated with a significant increase in prostate cancer knowledge (49% vs 62% correct responses; <i>P</i>&lt;.001), and men also experienced less decisional conflict (24 vs 15 on a scale of 0-100; <i>P</i>=.008). No changes in self-efficacy about decision making or screening preferences were observed. Most men (81%) reported that using PCSPrep prepared them to make informed decisions in partnership with their provider. CONCLUSIONS PCSPrep was an acceptable DA that improved men’s knowledge, reduced decisional conflict, and promoted the perception of being prepared for shared decision making. Further research is needed to test the DA in a larger randomized trial.


2004 ◽  
Vol 171 (4S) ◽  
pp. 334-334
Author(s):  
Walter J. Simoneaux ◽  
Caleb B. Bozeman ◽  
Brett S. Carver ◽  
Donald A. Elmajian

Cancer ◽  
2021 ◽  
Author(s):  
P. Travis Courtney ◽  
Rishi Deka ◽  
Nikhil V. Kotha ◽  
Daniel R. Cherry ◽  
Mia A. Salans ◽  
...  

Author(s):  
Jaclynn Hawkins ◽  
Karen Gilcher ◽  
Claudia Schwenzer ◽  
Michael Lutz

Extant research is growing in its ability to explain sex differences in novel coronavirus 2019 (COVID-19) diagnosis and mortality. Moving beyond comparisons based on biological sex is now warranted to capture a more nuanced picture of disparities in COVID-19 diagnosis and mortality specifically among men who are more likely to die of the illness. The objective of this study was to investigate racial disparities in COVID-19-related psychosocial, behavior and health variables among men. The present study utilizes a sample of 824 men who participated in a free health event held in a Midwestern state. Chi-square analysis showed that African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues (χ2 = 4.60 p = 0.03); higher COVID-19 diagnosis (χ2 = 4.60 p = 0.02); trouble paying for food (χ2 = 8.47, p = 0.00), rent (χ2 = 12.26, p = 0.00), medication (χ2 = 7.10 p = 0.01) and utility bills (χ2 = 19.68, p = 0.00); higher fear of contracting COVID-19 (χ2 = 31.19, p = 0.00); and higher rates of death of close friends and family due to COVID (χ2 = 48.85, p = 0.00). Non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men (χ2 = 10.21, p = 0.01). Regression analysis showed that race was a significant predictor of self-reported COVID-19 diagnosis (OR = 2.56, p < 0.05) after controlling for demographic characteristics. The results showed that compared to non-Hispanic White men, African American men were more likely to report an adverse impact of COVID-19 based on several factors including experiencing more COVID-19-related medical issues; higher COVID-19 diagnosis; trouble paying for food, rent, medication and utility bills; higher fear of contracting COVID-19; and higher rates of death of close friends and family due to COVID. Interestingly, non-Hispanic white men reported more increased stress levels due to COVID-19 compared to African American men.


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