PROSPEC: Using an information technology-supported patient-centered intervention to reduce disparities in prostate cancer screening discussions

Background. Prostate cancer screening among asymptomatic men is controversial because it is unclear that it reduces prostate cancer mortality and treatment can reduce quality of life. Current guidelines recommend that practitioners discuss screening with patients and that the decision to be screened should be one shared between patient and physician. However, this discussion and shared decision making is not as prevalent when the patient is African American, and thus at higher risk of prostate cancer. Objective/Purpose. The purpose of this project is to develop and evaluate a patient-centered intervention designed to address the racial disparity in the incidence and quality of prostate cancer screening-related discussions. This abstract reports on the intervention software design and development process. Methods. The purpose of the intervention is to provide men with knowledge and skills needed to initiate and participate in a discussion about prostate cancer screening with their physician. Its design was informed by qualitative research and an evidence-based ontology implemented in Protégé. The design process was derived from the Systems Model of Clinical Preventive Care hybridized with a rapid prototyping. The intervention scripts were developed by the entire research team. Professional actors were employed as characters in the scenario. Results. The intervention architecture uses elements from Cegala's PACE model of physician-patient communication. The intervention incorporates a simulated clinical encounter that models good physician-patient communication and provides educational content. The intervention incorporates tailoring on physician race and gender and patient race: users can choose the actors to play the role of the physician and patient in the scenario. Discussion/Conclusions. This intervention is the first to use informatics and information technology in focusing on racial disparities in discussing prostate cancer screening. The intervention is in the final stages of development prior to deployment in mid-2007 in a clustered community trial in primary care practices.