A Novel Decision Aid for Prostate Cancer Screening

前列腺癌筛查的新型决策辅助工具

• 批准号: 6965352
• 负责人: MARY E COSTANZA
• 金额: $ 20.9万
• 依托单位: UNIV OF MASSACHUSETTS MED SCH WORCESTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-11 至 2007-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6965352
• 关键词: behavioral /social science research tag; clinical research; computer assisted medical decision making; computer program /software; computer system design /evaluation; counseling; human subject; male; primary care physician; prostate neoplasms; prostate specific antigen; telemedicine

DESCRIPTION (provided by applicant): The goal of this R21 proposal is to develop, pilot test and evaluate a novel decision aid for prostate cancer screening that combines a computer assisted telephone counseling service with print materials to be used as a primary care provider (PCP) referral service to help men make an informed decision about whether to get Prostate Specific Antigen (PSA) testing. The decision aid will give men basic information about PSA, make them aware of the screening controversy, review the pros and cons of PSA testing and provide them with a values clarification exercise. The counseling will be tailored to the individual's stage of readiness to make an informed decision. The computer script and print materials used in this project will be suitable for use with men with marginal literacy and will be culturally appropriate for use with African-Americans (a subgroup at higher than average risk for prostate cancer). Stage-based counseling is a novel approach for decision aids. PSA testing is well suited for testing the effectiveness of this approach due to the controversy among professionals about its effectiveness in reducing mortality from prostate cancer and because of the risks of untoward side effects from aggressive treatment. To date, no decision aid for PSA testing has combined print materials, telephone counseling and a referral model. This combined approach is: 1) less expensive than on-site counselors, 2) provides live conversations, and 3) permits PCPs to leverage their time with patients by shifting the burden of basic education and values clarification to a credible referral service. Phase 1 includes focus groups and key informant interviews to inform intervention content that includes an existing award winning pamphlet (PROCASE), the development of new print and graphic materials and a new computerized counseling script. Phase 2 will pilot test 1) a letter from the PCP recommending the referral service and intervention print materials, 2) a counseling call and 3) a follow-up letter to the subject and his referring PCP. Outcomes are: effectiveness of the counseling service; acceptability of the intervention and feasibility of the counseling service. If successful, this decision aid can be tested in a randomized controlled trial against other standard decision aids.

描述（由申请人提供）：该R21提案的目的是开发，试点测试并评估对前列腺癌筛查的新决策辅助，该筛查结合了计算机辅助电话咨询服务与印刷材料，将用作主要护理提供者（PCP）推荐服务，以帮助男性做出有关是否获得前列腺特定的抗原（PSA）测试的知情决策。决策援助将为男人提供有关PSA的基本信息，使他们意识到筛选争议，审查PSA测试的优缺点，并为他们提供值的澄清练习。咨询将量身定制为个人准备做出明智决定的阶段。该项目中使用的计算机脚本和印刷材料将适合与具有边际识字的男性一起使用，并且在文化上适合与非裔美国人（一个高于平均风险的前列腺癌风险）一起使用。基于阶段的咨询是一种新型决策辅助方法。 PSA测试非常适合测试这种方法的有效性，这是由于专业人员之间的争议在降低前列腺癌死亡率的有效性以及积极治疗中不受欢迎的副作用的风险。迄今为止，PSA测试的决策援助尚未结合印刷材料，电话咨询和推荐模型。这种合并的方法是：1）比现场辅导员便宜，2）提供实时对话，3）允许PCP通过将基础教育的负担和价值澄清的负担转移到可靠的推荐服务来利用患者的时间。 第1阶段包括焦点小组和主要线人访谈，以告知干预内容，其中包括现有的获奖小册子（Procase），开发新印刷品和图形材料以及新的计算机咨询脚本。第2阶段将驾驶测试1）PCP的一封信，建议推荐服务和干预印刷材料，2）咨询电话和3）给该主题及其推荐PCP的后续信。结果是：咨询服务的有效性；咨询服务的干预和可行性的可接受性。如果成功，可以在针对其他标准决策辅助工具的随机对照试验中对该决策援助进行测试。