It's A Big Decision

Background: African-American (AA) men bear a disproportionate burden of prostate cancer (CaP) diagnosis and mortality. Current opinions regarding the value of CaP screening differ among various medical organizations. Therefore, it is important that AA men have appropriate and understandable information to make informed decisions about CaP screening. Decision aids have been recommended to facilitate informed decision-making (IDM) for CaP screening. Purpose: To develop a culturally relevant prostate cancer screening decision aid for African-American men ages 40-70. Methods: In concert with the International Patient Decision Aid Standards, we have adapted the Edutainment Decision Aid Model to develop a CaP screening decision aid. Specifically, we produced a culturally appropriate video titled, “It's a Big Decision.” We used superficial and deep tailoring strategies to create a culturally relevant video that would be engaging and informative. Superficial tailoring included the casting of nine local African-American actors to communicate the potential benefits and uncertainties of prostate cancer screening. In addition, we used culturally relevant settings (e.g. barbershop scenes were shot at one of the barbershops enrolled in the project). Our strategies for incorporating deep tailoring included culturally appropriate scenarios (e.g. husband and wife), language, and humor. We conducted qualitative interviews with African-American men recruited from local barbershops to provide a framework for the deep tailoring. Based on the Edutainment model, the video follows three men as they contemplate decisions about prostate cancer screening. The storylines of these three main characters are interwoven with learning modules that provide facts about prostate cancer and prostate cancer screening. Results: African-American men have found the video engaging and informative. Conclusion: The Edutainment Decision Aid Model is an appropriate strategy to develop prostate cancer screening aids for African-American men ages 40-70. Future research is needed to determine which components are most associated with decision quality for prostate cancer screening decisions.