Low-Literacy Interventions to Promote Discussion of Prostate Cancer

Autor: Armin D. Weinberg, Megan Price, Sunil Kripalani, Elizabeth Justice, Cynthia A. Spiker, Jeb Justice, Larry Laufman, Jyoti Sharma
Rok vydání: 2007
Předmět:
Zdroj: American Journal of Preventive Medicine. 33:83-90
ISSN: 0749-3797
Popis: Background Professional organizations recommend that physicians discuss prostate cancer with patients to make individual screening decisions. However, few studies have tested strategies to encourage such discussions, particularly among high-risk populations. We examined the effects of two low-literacy interventions on the frequency of prostate cancer discussion and screening. Design Randomized, blinded, controlled trial with concealed allocation. Setting/Participants Inner-city primary care clinic, serving a predominately African-American population. Participants were men aged 45–70 with no history of prostate cancer, presenting for a regular appointment. Interventions While waiting to see their physician, patients received a patient education handout on prostate cancer screening (PtEd), a handout simply encouraging patients to talk to their doctor about prostate cancer (Cue), or a control handout. The interventions did not advocate for or against screening. Measures Patient-reported discussion of prostate cancer with the physician and chart reviews determine prostate-specific antigen (PSA) test orders and performance of digital rectal examination (DRE). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were computed. Data were collected in 2003, and analyses were completed in 2006. Results Most of the 250 subjects (90.4%) were African American and 78.8% read below the ninth grade level. Overall, 48.4% reported discussing prostate cancer during the appointment. Compared to the control group (37.3%), discussions were significantly more common in the Cue group (58.0%, aOR=2.39 [1.26–4.52]), as well as in the PtEd group (50.0%, aOR=1.92 [1.01–3.65]). When prostate cancer was discussed, patients in the intervention groups more commonly initiated the conversation (47.6% PtEd and 40.0% Cue, vs 9.7% control, p Conclusions Two simple low-literacy interventions significantly increased discussion of prostate cancer and PSA test orders but not performance of DRE. Both interventions were effective in empowering low-literacy patients to initiate conversations about prostate cancer with their physician.
Databáze: OpenAIRE
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