Frencher Stanley K, Sharma Arun K, Teklehaimanot Senait, Wadzani Dennis, Ike Ijeoma E, Hart Alton, Norris Keith
Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, 650 Charles E Young Dr. South, 66-115 CHS, Los Angeles, CA, 90095, USA.
Department of Research - Life Sciences Institute, Charles R. Drew University of Medicine and Science, 1731 E 120th St, Los Angeles, CA, 90059, USA.
J Cancer Educ. 2016 Sep;31(3):506-13. doi: 10.1007/s13187-015-0871-7.
The objective of this study was to investigate the effectiveness of using decision support instruments (DSI) to assist African-American (AA) men in making a prostate cancer (CaP) screening decision. This nonrandomized pretest-posttest comparison study assessed two DSI that were either culturally tailored or culturally nonspecific. CaP knowledge, intention to screen, and preferences were assessed before and after exposure to DSI using a convenience sample of 120 AA men aged 40 years and above. Participants interested in screening were referred to healthcare providers through a community-based patient navigator to obtain prostate-specific antigen (PSA) testing. We followed up 3 months after to determine if participants screened for CaP. CaP knowledge increased following exposure to both DSI in equivalent proportions. While similar proportions of men ultimately intended on having a PSA test following both DSI, bivariate analysis revealed that the culturally tailored DSI demonstrated a statistically significant increase in intention to screen. Participants' degree of certainty in their decision-making process with regard to CaP screening increased following the culturally tailored DSI (p < .001). The majority of participants planned on discussing CaP screening with a healthcare provider upon completion of the study. Barbershop-based health education can change the knowledge, preferences, intentions, and behaviors of this at-risk population. At 3 months follow-up, half (n = 58) of the participants underwent PSA testing, which led to the diagnosis of CaP in one participant. Community-led interventions for CaP, such as cluster-randomized designs in barbershops, are needed to better assess the efficacy of DSI in community settings.
本研究的目的是调查使用决策支持工具（DSI）协助非裔美国（AA）男性做出前列腺癌（CaP）筛查决策的有效性。这项非随机的前测-后测对比研究评估了两种DSI，一种是根据文化定制的，另一种是无特定文化针对性的。使用120名年龄在40岁及以上的AA男性便利样本，在接触DSI之前和之后评估了CaP知识、筛查意愿和偏好。对筛查感兴趣的参与者通过社区患者导航员被转介给医疗服务提供者，以进行前列腺特异性抗原（PSA）检测。我们在3个月后进行随访，以确定参与者是否进行了CaP筛查。接触两种DSI后，CaP知识以相同比例增加。虽然两种DSI之后最终打算进行PSA检测的男性比例相似，但双变量分析显示，根据文化定制的DSI在筛查意愿上有统计学显著增加。在使用根据文化定制的DSI后，参与者在CaP筛查决策过程中的确定程度有所提高（p < .001）。大多数参与者计划在研究结束后与医疗服务提供者讨论CaP筛查。基于理发店的健康教育可以改变这一高危人群的知识、偏好、意愿和行为。在3个月的随访中，一半（n = 58）的参与者进行了PSA检测，其中一名参与者被诊断为CaP。需要社区主导的CaP干预措施，如理发店中的整群随机设计，以更好地评估DSI在社区环境中的疗效。
