Disseminating Decision Support to Men with Localized Prostate Cancer

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Prostate cancer is the most common cancer in men. For men with localized (non-metastatic) disease, prostate cancer is unique in having a wide range of options, from active surveillance (scheduled monitoring) to active treatments (surgery, radiation). These options have tradeoffs in terms of disease control, overall survival and quality of life impact (including urinary, sexual and bowel dysfunction. Decision aids (DA) in prostate cancer have been shown to directly improve patient knowledge by presenting information about the diagnosis (including aggressiveness of each patient's cancer), treatment options (including efficacy and side effects), and assisting in treatment decision-making. The Personal Patient Profile – Prostate (P3P), created by Dr. Berry (MPI) funded by both the National Cancer Institute and the National institute of Nursing Research, is a DA that has been extensively tested and validated in diverse samples (e.g. racial/ethnic minorities, lower health literacy) through several prospective trials, and is available in English and Spanish. P3P provides information to patients through interactive tailored text and videos; and solicits each patient's preferences to help inform a decision that best fits a patient's diagnosis and personal values. The ability to access and complete P3P online, on any device, makes it a uniquely promising tool that could be provided directly to patients and widely accessed. By extending the reach of an efficacious DA, patients can complete the P3P modules online, learn about treatment options (including active surveillance) and clarify their preferences, in preparation for consultation discussions with their providers. The long-term goal of this research is to improve shared decision-making and help prostate cancer patients make informed decisions regarding treatment. The overall objective of this application is to assess the feasibility and acceptability to patients and providers of delivering P3P on a population-level directly to men with prostate cancer. We will work with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry to directly contact and deliver P3P access (P3PConnect) to newly-diagnosed prostate cancer patients who reside throughout North Carolina. We plan to quantify the reach of P3P when delivered on a population- level among newly diagnosed prostate cancer patients in NC, identify determinants of P3P use among newly diagnosed patients with prostate cancer, and explore physician perspectives on potential or actual P3P use by their own patients. Successful population-based dissemination of DAs will dramatically increase the reach and impact of these efficacious tools; and determinants of implementation learned from this study can be adapted for use in other cancers, thereby significantly changing the way DAs will be used in the future.