Pre-Implementation assessment of a computerized intervention to reduce the racial disparity in prostate cancer screening discussions

Background: Current guidelines recommend that men should discuss prostate cancer screening (PCS) with their provider. Patient race often affects the frequency and quality of these discussions.

Objectives: To assess a new computerized interactive intervention that is tailored on race and designed to teach patients how to start and engage in a discussion about PCS with their provider. The intervention provides basic information about PCS and uses actors to model a shared decision-making process.

Methods: We report data from semi-structured interviews of men, aged 44-65, (n=20; 5=Caucasian, 15 African American), recruited from the community to watch the intervention. Qualitative analysis was performed by three independent coders on three dimensions: intent to discuss PCS at their next appointment, intent to have PCS, and perception of risk.

Results: After watching the intervention, all participants indicated they were likely to speak with their provider about PCS; 45% intended to have PCS; 40% indicated that they maybe/probably would have PCS. Participants who believed they were at risk for PC were more likely to indicate intent to be screened. 35% reported higher perceived risk after watching the intervention while 5% reported lower perceived risk; 40% felt that the intervention made them more comfortable about discussing PCS with their provider.

Conclusions: These data suggest that a computerized interactive intervention modeling shared decision-making encourages men to discuss PCS with their provider, an outcome that may be partially mediated by higher perceived risk and increased comfort with the issue. The intervention is currently being evaluated in a community-based study.