Prostate Cancer Education in African American Men

描述(申请人提供)：相对于其他种族和民族，非裔美国人男性前列腺癌(CAP)的患病率更高，更有可能在晚期出现疾病，通常患有更具侵袭性的肿瘤，更有可能死于CAP，并且往往对CAP风险以及CAP筛查的潜在危害和好处知之甚少。目前还没有关于CAP筛查的全国性共识，但实践指南建议教育男性，特别是高风险男性，了解CAP筛查的好处和危害，以支持男性做出有关CAP筛查的明智决定。这项拟议的研究旨在：(A)评估量身定做的电话干预在增加非裔美国人男性在知情情况下选择上限筛查方面的知识和技能方面的有效性，(B)确定干预的调解人和主持人，以及(C)探索上限筛查的预测因素，以了解男性决定进行筛查的原因。目标人群是年龄在45岁至70岁之间的非洲裔美国男性，他们参加了1199国家福利基金，这是美国最大的医疗工作者工会的医疗保险基金。500名符合条件并同意的男性将收到一本关于帽子筛查的优点和局限性的印刷小册子，然后他们将被随机分配接受量身定制的电话帽子筛查教育或关于饮食和癌症风险的安慰剂(注意力控制)电话教育。定制电话教育项目旨在作为决策支持干预，并以渥太华医疗决策框架为基础。主要研究结果是CAP决策变量(患者决策冲突、患者价值观与CAP筛查决策的一致性)和沟通变量(患者与医生讨论CAP以及CAP筛查决策中的份额)。其他重要的结果包括有关CAP和筛查的知识、感知的决策支持以及感知到的与医生沟通的有效性。数据将通过患者访谈、医生报告以及基线和干预后6个月的医疗表和索赔审查来收集。这项建议解决了对非裔美国人进行帽子筛查教育的强烈需求，以此作为加强关于帽子筛查的个人化、知情和共享决策的一种方式。通过确保干预内容在理论上站稳脚跟、目标人群可以接受、在时间上可行、切实可行并允许个体化，拟议的干预战略有可能得到广泛传播，如果证明有效的话。

DESCRIPTION (provided by applicant): Relative to other racial and ethnic groups, African American men have a higher prevalence of cancer of the prostate (CaP), are more likely to present with disease at later stages, often have more aggressive tumors, are more likely to die from CaP, and tend to be less knowledgeable about CaP risk and the potential harms and benefits of CaP screening. There is no national consensus on screening for CaP, but practice guidelines recommend educating men, especially high-risk men, about the benefits and harms of CaP screening to support men in making informed decisions about CaP screening. The proposed study aims to: (a) evaluate the efficacy of a tailored telephone intervention in increasing knowledge and skills among African American men related to making an informed choice about CaP screening, (b) identify mediators and moderators of the intervention, and (c) explore predictors of CaP screening to understand why men decide to screen or not. The target population is African American men between the ages of 45 - 70 years old enrolled in the 1199 National Benefit Fund, the health care insurance fund for the largest health care workers union in the United States. Five hundred eligible and consenting men will receive a print brochure on the advantages and limitations of CaP screening and will then be randomized to receive either tailored-telephone CaP screening education or placebo (attention control) telephone education about diet and cancer risk. The tailored-telephone education program is designed as a decision support intervention and is based on the Ottawa Framework of medical decision-making. Main study outcomes are CaP decision variables (patient decision conflict, congruence between patient values and CaP screening decision) and communication variables (patient discusses CaP with physician and shares in CaP screening decision). Other important outcomes include knowledge about CaP and screening, perceived decision support, and perceived efficacy to communicate with physician. Data will be collected through patient interviews, physician reports, and medical chart and claims review at baseline and 6 -months post-intervention. This proposal addresses the strong need to educate African American men about CaP screening as a way of enhancing individualized, informed and shared decision making regarding CaP screening. By ensuring that the intervention components are theoretically grounded, acceptable to the target population, feasible in terms of time, practical, and allow for individualization, the proposed intervention strategy has the potential to be widely disseminated if efficacy is demonstrated.