Fostering informed-decision making about prostate cancer screening, diagnosis and treatment among clinicians and African American men

研究项目3：促进临床医生和非裔美国男性对前列腺癌的知情决策 项目摘要/摘要 尽管多年来积极的前列腺癌(PrCa)筛查做法和美国死亡率的下降， 非洲裔美国男性仍然是PrCA发病率和死亡率最高的。此外，非洲裔美国人 男性患PRCA的年龄较早，而且更有可能出现晚期疾病。 尽管美国预防服务工作组(USPSTF)此前建议针对PrCA 筛查，更新的指南草案现在建议患者和临床医生共同做出决定- 制定程序，根据个人情况确定谁应该使用PrCA筛查。这是共享的 决策过程对非裔美国人男性构成了独特的挑战，因为PrCA的临床试验 筛查缺乏种族多样性，因此提供的医学证据有限，并考虑到结构性因素 这阻碍了共同的医疗决策，例如更有可能出现健康素养问题。vt.给出 路易斯安那州的PrCA发病率和死亡率分别位居第二和第七，考虑到非洲 美国人占大新奥尔良地区人口的近一半，泽维尔大学 路易斯安那州处于独特的地位，可以解决非裔美国人和 充分利用USPSTF准则的应用。该项目将由Pi Margarita Echeverri博士领导， 路易斯安那州泽维尔大学的行为和健康差异研究员，以及共同的Pi Michael Hoerger， 杜兰大学的临床心理学家、方法论专家和心理社会肿瘤学研究员 大学。他们在制定健康教育干预措施方面有经过证明的记录，包括癌症101 针对非裔美国人(癌症101AA)和癌症护理的价值观和选择(VOICE)，将进行调整 在这项调查中重点关注PrCA筛查决定。我们提出三个目标来改进PrCa筛查 非洲裔美国男性的决策。(1)改编《癌症101AA》，发声教育干预 根据非裔美国人男性、前列腺癌患者、 和临床医生。(2)评估适应干预措施相对于以下控制程序的有效性 改善决策(知识、信心和决策自我效能)和次级临床 结果(对风险和收益的看法、筛查意图、决策流程和患者- 临床医生交流)在一项涉及50名临床医生和200名非洲裔美国人男性的随机临床试验中 初级保健。(3)评估干预措施的可接受性和有效性，为更广泛的后续行动提供信息 调查。这项研究将建立可能有助于减少种族差距的知识。 PRCA，指导最终临床试验的发展，这将在全国范围内改变政策和指南，以及 进一步发展路易斯安那州癌症差异研究的能力。

Research Project 3: Fostering informed decision-making on prostate cancer among Clinicians and African American men Project Summary/Abstract Despite years of aggressive prostate cancer (PrCa) screening practices and declines in mortality in the U.S., African American men still have the highest PrCa incidence and mortality rates. Moreover, African American men experience an earlier age of onset of PrCA and are more likely to present with advanced disease. Although the U.S. Preventive Services Task Force (USPSTF) previously recommended against PrCa screening, updated draft guidelines now recommend that patients and clinicians engage in a shared decision- making process to determine on an individualize basis who should utilize PrCa screening. This shared decision-making process poses unique challenges for African American men, given that clinical trials of PrCa screening have lacked racial diversity and thus contribute limited medical evidence, and given structural factors that impede shared healthcare decision making such as greater likelihood of health literacy concerns. Given that Louisiana has the 2nd highest incidence and 7th highest mortality rate of PrCa, and given that African Americans constitute nearly half the population of the Greater New Orleans area, Xavier University of Louisiana is uniquely positioned to address cancer health literacy barriers among African Americans and leverage the application of the USPSTF guidelines. The project will be led by PI Margarita Echeverri, PhD, a behavioral and health disparities researcher at Xavier University of Louisiana, and co-PI Michael Hoerger, PhD, MSCR, a clinical psychologist, methodologist, and psychosocial oncology researcher at Tulane University. They have proven track records of developing health education interventions, including Cancer 101 for African Americans (Cancer101AA) and Values and Options in Cancer Care (VOICE), which will be adapted to focus on PrCa screening decisions in this investigation. We propose three aims to improve PrCa screening decision making for African American men. (1) Adapt the Cancer101AA and VOICE educational interventions for PrCa screening decision making based on input from African American men, patients with prostate cancer, and clinicians. (2) Assess the effectiveness of the adapted interventions relative to a control program for improving decision making (knowledge, confidence, and decision self-efficacy) and secondary clinical outcomes (perceptions of risks and benefits, intentions to screen, decision making processes, and patient- clinician communication) in a randomized clinical trial involving 50 clinicians and 200 African American men in primary care. (3) Evaluate the acceptability and effectiveness of the interventions to inform a broader follow-up investigation. This research will build knowledge that may contribute to the reduction of racial disparities in PrCa, guide the development of a definitive clinical trial that would shift policy and guidelines nationwide, and further develop the capacity for cancer disparities research in Louisiana.