Sunil Kripalani|Jyoti Sharma|Elizabeth Justice|Jeb M. Justice|C Spiker|Larry Laufman|Megan Price|Armin D. Weinberg
Low-Literacy Interventions to Promote Discussion of Prostate Cancer
Emory University|Emory University|Emory University|Emory University|Baylor College of Medicine|Baylor College of Medicine|Georgia Department of Public Health|Baylor College of Medicine
professional organizations recommend physicians discuss prostate cancer patients make individual screening decisions however studies tested strategies encourage discussions particularly among highrisk populations examined effects two lowliteracy interventions frequency prostate cancer discussion screeningrandomized blinded controlled trial concealed allocationinnercity primary care clinic serving predominately africanamerican population participants men aged 4570 history prostate cancer presenting regular appointmentwhile waiting see physician patients received patient education handout prostate cancer screening pted handout simply encouraging patients talk doctor prostate cancer cue control handout interventions advocate screeningpatientreported discussion prostate cancer physician chart reviews determine prostatespecific antigen psa test orders performance digital rectal examination dre adjusted odds ratios aor 95 confidence intervals ci computed data collected 2003 analyses completed 2006most 250 subjects 904 african american 788 read ninth grade level overall 484 reported discussing prostate cancer appointment compared control group 373 discussions significantly common cue group 580 aor239 126452 well pted group 500 aor192 101365 prostate cancer discussed patients intervention groups commonly initiated conversation 476 pted 400 cue vs 97 control p001 comparison control compared control group 24 psa test orders increased pted group 141 aor762 1623583 cue group 123 aor586 1242781 documentation dre change significantly 47 pted 62 cue 60 controltwo simple lowliteracy interventions significantly increased discussion prostate cancer psa test orders performance dre interventions effective empowering lowliteracy patients initiate conversations prostate cancer physician