Internet-Based Education for Prostate Cancer Screening

前列腺癌筛查网络教育

• 批准号: 7192499
• 负责人: Kathryn L Taylor
• 金额: $ 37.41万
• 依托单位: GEORGETOWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-03-01 至 2011-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7192499
• 关键词: Address; African American; Age; Area; Attitude; Behavior; Belief; Benefits and Risks; Caring; Cessation of life; Characteristics; Classification; Cognitive; Commit; Communities; Complex; Comprehension; Computer Literacy; Computers; Condition; Data; Decision Aid; Decision Making; Detection; Development; Disease; District of Columbia; Early Diagnosis; Education; Educational Intervention; Effectiveness; Elderly; Equilibrium; Evaluation; Future; Goals; Health; Health education; Hospitals; Individual; Informed Consent; Internet; Intervention; Judgment; Knowledge; Knowledge acquisition; Malignant Neoplasms; Malignant neoplasm of prostate; Mediating; Mediator of activation protein; Medical; Methods; Minority; Morbidity - disease rate; Numbers; Online Systems; Outcome; Outcome Assessment; Participant; Patient Education; Patients; Personal Satisfaction; Persons; Phase; Primary Health Care; Printing; Procedures; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Rate; Recommendation; Recording of previous events; Relative (related person); Reporting; Research; Role; Sampling; Screening Result; Screening for Prostate Cancer; Screening procedure; Structure of base of prostate; Target Populations; Technology; Upper arm; Washington; base; cancer diagnosis; cancer education; cohort; college; design; follow-up; health related quality of life; improved; innovation; interest; literate; male; men; mortality; novel; programs; satisfaction; success; tool; treatment effect

DESCRIPTION (provided by applicant): Prostate cancer (PCa) is the leading cancer diagnosis among men and the second leading cause of male cancer death. However, screening asymptomatic men remains controversial, as early diagnosis and treatment of PCa has not yet demonstrated reduced disease-related mortality in a randomized trial. The goal of the current study is to develop and assess widely accessible, easily disseminable methods to assist men in making informed decisions about PCa screening. We will compare the efficacy of a new web-based, interactive decision support approach to our existing print-based PCa screening decision tool, among a diverse sample of male primary care patients. Abundant evidence documents the expanding role of the Internet in increasing access to and understanding of health information and the need for systematic evaluations of Internet-based interventions. A novel aspect of the proposed trial will be our focus on cognitive biases as a factor that has limited the success of previous information-based interventions. Specifically, we will evaluate: 1) confirmation bias and 2) short-term consequences bias. In Phase I (months 1-8) of this five-year project, we will develop an interactive, Internet-based, patient information and decision aid. In Phase II (months 9-60), we will evaluate the impact of this decision aid in a randomized controlled trial with male primary care patients aged 45-70 from two Washington, DC, area hospitals (N = 1875). Trial arms include: 1) print-based information and decision aid (Print), 2) web-based information plus interactive decision aid (Web), and 3) usual care (UC). Subjects will complete outcome assessments at baseline, one- and 13-months post-baseline. The specific aims are to: 1. Evaluate the impact of the delivery method (Web vs. Print vs. Usual Care) on the key patient outcome variables of knowledge, decisional satisfaction, and the screening decision. 2. Identify factors that moderate the interventions' impact on the primary outcomes. 3. Identify the mechanisms by which the interventions impact knowledge and decisional satisfaction. In exploratory analyses, we will evaluate factors that are related to use of the web and print materials. This research has the potential to make several significant and innovative contributions: 1) the development and evaluation of a widely-disseminable method of educating a heterogeneous group of patients about a controversial topic, which can be adapted for other similarly contentious issues, 2) a determination of whether Web based materials are a feasible method of patient education for this age cohort, compared to print materials, 3) an understanding of cognitive factors that may hinder comprehension of a controversial medical decision, 4) a determination of who among the target population benefits the most from a web-based intervention, and 5) the information required to streamline and target future web-based educational interventions.

描述(申请人提供)：前列腺癌(PCa)是男性的主要癌症诊断，也是男性癌症死亡的第二大原因。然而，筛查无症状男性仍然存在争议，因为在随机试验中，早期诊断和治疗前列腺癌尚未显示出与疾病相关的死亡率降低。目前这项研究的目标是开发和评估可广泛使用、易于传播的方法，以帮助男性做出关于PCA筛查的知情决定。我们将在不同的男性初级保健患者样本中，比较一种新的基于网络的交互式决策支持方法与我们现有的基于印刷的PCA筛查决策工具的有效性。大量证据表明，互联网在增加对保健信息的获取和了解方面的作用日益扩大，需要对基于互联网的干预措施进行系统评价。拟议试验的一个新方面将是我们将重点放在认知偏差上，因为认知偏差是限制先前基于信息的干预成功的一个因素。具体地说，我们将评估：1)确认偏差和2)短期后果偏差。在这个五年计划的第一阶段(1-8个月)，我们将开发一个交互式的、基于互联网的患者信息和决策辅助工具。在第二阶段(9-60个月)，我们将对来自华盛顿特区两家地区医院(N=1875)的45-70岁男性初级保健患者进行随机对照试验，评估这种决策辅助的影响。试验武器包括：1)基于印刷的信息和决策辅助(印刷)，2)基于网络的信息加交互式决策辅助(Web)，以及3)日常护理(UC)。受试者将在基线、基线后1个月和13个月后完成结果评估。具体目的是：1.评估交付方法(网络、印刷和日常护理)对关键患者结果变量的影响，这些变量包括知识、决策满意度和筛查决策。2.找出缓和干预措施对主要结果影响的因素。3.确定干预措施影响知识和决策满意度的机制。在探索性分析中，我们将评估与使用网络和印刷材料有关的因素。这项研究有可能做出几项重大和创新的贡献：1)开发和评估一种广泛传播的方法，就一个有争议的主题对不同的患者群体进行教育，这种方法可以适用于其他类似的有争议的问题；2)确定与印刷材料相比，基于网络的材料是否是该年龄段队列患者教育的可行方法；3)了解可能阻碍理解有争议的医疗决定的认知因素；4)确定目标人群中谁从基于网络的干预中受益最大；以及5)确定精简和针对未来基于网络的教育干预所需的信息。