Shared decision-making (SDM) is recommended for prostate cancer screening, but little is known about how this process is perceived by patients and providers. SDM is especially important for African American men, who are at high risk for the disease.
To evaluate agreement in SDM ratings among patients, providers, and objective observers.
African American men ages 45-70 were recruited from primary care practices to participate in a study evaluating a decision aid (DA). Immediately after using the DA, patients proceeded to primary care appointments. Afterwards, patients and physicians completed surveys assessing perceptions about SDM. Clinical visits were also audio-recorded and coded to assess SDM.
Mean scores on SDM measures among patients were 73.2 (SD = 27.5, 95% CI 55.71-90.62), 83.1 among physicians (SD = 7.8 95% CI 78.14-88.06), and 67.1 among objective raters (SD = 36.8 95% CI 43.72-90.45). Among patient-provider dyads, mean agreement was 49.9%.
Patients, physicians, and objective observers perceived SDM differently. Understanding discordant experiences of SDM is vital for improving clinical guidance about SDM especially among African Americans who have historically faced healthcare discrimination and mistrust. DAs, particularly for African American men, should incorporate strategies to empower patients to advocate for their communication needs and preferences.
Clinical trials identifier number: NCT02787434.
Journal of racial and ethnic health disparities. 2021 Jun 15 [Epub ahead of print]
Jennifer D Allen, Thalia Porteny, Amy Kaplan, Keren Ladin, Kyle Monahan, Donna L Berry
Department of Community Health, School of Arts and Sciences, Tufts University, 574 Boston Avenue, Medford, MA, 02155, USA. ., Department of Occupational Therapy, Tufts University, 574 Boston Avenue, Medford, MA, 02155, USA., Department of Community Health, School of Arts and Sciences, Tufts University, 574 Boston Avenue, Medford, MA, 02155, USA., Research Technology, Tufts Technology Services, Tufts University, 574 Boston Ave, Medford, MA, 02155, USA., Department of Biobehavioral Nursing and Health Informatics, University of Washington, 1959 NE Pacific Street, WA, 98195, Seattle, USA.