Disseminating Decision Support to Men with Localized Prostate Cancer

前列腺癌是男性最常见的癌症。对于患有局限性(非转移性)疾病的男性，前列腺癌 癌症的独特之处在于有广泛的选择，从主动监测(计划监测)到主动监测 治疗(手术、放射治疗)。这些选择在疾病控制、总存活率和 对生活质量的影响(包括排尿、性功能和肠道功能障碍。前列腺癌中的辅助决策(DA) 通过提供有关诊断的信息(包括 每个患者癌症的侵袭性)、治疗选择(包括疗效和副作用)以及辅助 在治疗决策中。个人患者档案--前列腺(P3P)，由贝瑞博士(MPI)资助创建 由国家癌症研究所和国家护理研究所共同发起的，是一项已经 在不同的样本中进行了广泛的测试和验证(例如，种族/民族少数群体，较低的健康素养)，通过 几个预期的试验，并提供英语和西班牙语。P3P通过以下方式向患者提供信息 交互式定制文本和视频；征求每个患者的偏好，以帮助做出最适合的决定 病人的诊断和个人价值。在任何设备上在线访问和完成P3P的能力使 它是一个独特的有前景的工具，可以直接提供给患者并广泛使用。通过扩展 通过有效的DA，患者可以在线完成P3P模块，了解治疗方案 (包括主动监视)，并澄清他们的偏好，为与其进行咨询讨论做准备 供应商。这项研究的长期目标是改善共同的决策并帮助前列腺癌 患者会在知情的情况下做出治疗决定。此应用程序的总体目标是评估 患者和提供者在人群水平上直接向男性患者提供P3P的可行性和可接受性 前列腺癌。我们将与北卡罗来纳州中央癌症快速病例确定系统合作 注册中心直接联系并向新诊断的前列腺癌患者提供P3P接入(P3PConnect) 居住在整个北卡罗来纳州。我们计划量化P3P在人群中的覆盖范围- 北卡罗来纳州新诊断前列腺癌患者的P3P水平，确定新诊断前列腺癌患者使用P3P的决定因素 诊断患有前列腺癌的患者，并通过以下方式探索医生对潜在或实际使用P3P的看法 他们自己的病人。成功的以人群为基础的DAS传播将极大地扩大覆盖范围和 这些有效工具的影响；从这项研究中了解到的执行决定因素可以加以调整 用于其他癌症，从而显著改变了DAS在未来的使用方式。

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.