Limited Evidence of Shared Decision Making for Prostate Cancer Screening in Audio-Recorded Primary Care Visits Among Black Men and their Healthcare Providers.

Autor: Stevens ER; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA. Elizabeth.Stevens@nyulangone.org., Thomas J; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.; Department of Urology, NYU Langone Health, New York, NY, USA.; VA New York Harbor Healthcare System, New York, NY, USA., Martinez-Lopez N; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Fagerlin A; Department of Population Health Sciences, University of Utah Spencer Eccles School of Medicine, Salt Lake City, UT, USA.; VA Salt Lake City Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA., Ciprut S; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.; Department of Urology, NYU Langone Health, New York, NY, USA.; VA New York Harbor Healthcare System, New York, NY, USA., Shedlin M; NYU College of Nursing, New York, NY, USA., Gold HT; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Li H; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Davis JK; The Fuqua School of Business, Duke University, Durham, NC, USA., Campagna A; The Fuqua School of Business, Duke University, Durham, NC, USA., Bhat S; Sunset Park Health Council, Brooklyn, NY, USA., Warren R; National Center for Bioethics in Research and Health Care, Tuskegee University, Tuskegee, USA., Ubel P; The Fuqua School of Business, Duke University, Durham, NC, USA., Ravenell JE; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA., Makarov DV; Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.; Department of Urology, NYU Langone Health, New York, NY, USA.; VA New York Harbor Healthcare System, New York, NY, USA.
Jazyk: angličtina
Zdroj: Journal of immigrant and minority health [J Immigr Minor Health] 2024 Jun 01. Date of Electronic Publication: 2024 Jun 01.
DOI: 10.1007/s10903-024-01606-5
Abstrakt: Prostate-specific antigen (PSA)-based prostate cancer screening is a preference-sensitive decision for which experts recommend a shared decision making (SDM) approach. This study aimed to examine PSA screening SDM in primary care. Methods included qualitative analysis of audio-recorded patient-provider interactions supplemented by quantitative description. Participants included 5 clinic providers and 13 patients who were: (1) 40-69 years old, (2) Black, (3) male, and (4) attending clinic for routine primary care. Main measures were SDM element themes and "observing patient involvement in decision making" (OPTION) scoring. Some discussions addressed advantages, disadvantages, and/or scientific uncertainty of screening, however, few patients received all SDM elements. Nearly all providers recommended screening, however, only 3 patients were directly asked about screening preferences. Few patients were asked about prostate cancer knowledge (2), urological symptoms (3), or family history (6). Most providers discussed disadvantages (80%) and advantages (80%) of PSA screening. Average OPTION score was 25/100 (range 0-67) per provider. Our study found limited SDM during PSA screening consultations. The counseling that did take place utilized components of SDM but inconsistently and incompletely. We must improve SDM for PSA screening for diverse patient populations to promote health equity. This study highlights the need to improve SDM for PSA screening.
(© 2024. The Author(s).)
Databáze: MEDLINE
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