Project Overview +

DVDs demonstrate to patients some of the issues that might arise during their prostate cancer diagnosis visit that may prevent them from sharing in the decision of what treatment to choose. The DVDs also provide solutions that would allow for patients' participation in the treatment decision making process.

Related Media +

Related Media:

Aims +

This study aims to explore if there are differences between participants who receive a written decision aid alone versus those who received the written decision aid plus a DVD decision aid.

  1. Does the use of the DVD modeling patient communication strategies increase patients' perceptions of the importance of their preferences to their decision making?
  2. Does the use of the DVD increase patients' perceptions of their intention to discuss their values and preferences with their urologists and radiation oncologists?
  3. Does the use of the DVD increase patients' actual engagement with their physician during the clinical encounter (using the audio recordings of the conversations)?
  4. Does the use of the DVD increase the concordance between patient decision making preferences and actual decision making outcomes?
  5. Does the use of the DVD increase long term satisfaction with decision on type of treatment selected?
  6. Does the use of the DVD influence patient perception of his physician (e.g., trust) and of the diagnosis visit?
  7. Does the use of the DVD increase patient satisfaction with their decision and the decision making process?

Participants +

Participants are recruited from University of Michigan Urology Clinics. We recruit men aged 18 years and older at the time of biopsy; that is those men who are undergoing a prostate biopsy to test for prostate cancer but have not yet received their results. Other inclusion criteria include the ability to read and answer questions in English. Men previously diagnosed with prostate cancer are excluded.

Intervention +

A research team member meets in person with the potential patient participant in exam room or other private area in clinic to invite him to participate in the study, and if interested, enroll him.

At the time of recruitment we conduct a baseline survey (S1) including determination of eligibility. We then randomize eligible participants to receive the brochure DA (decision aid) "Making the Choice: Deciding What to Do About Early Stage Prostate Cancer" alone or the brochure DA plus a DVD decision aid that provides instruction and recommendations on how to participate in shared decision making with one's physician.

The DAs are provided to participants to give them time to review materials before meeting to discuss biopsy results and treatment options with the urologist and/or radiation oncologist.

Prior to receiving biopsy results we administer a survey (S2) over the telephone with participants in order to measure their pre-visit intentions. This second survey includes questions regarding their reactions to the DA(s), their perceptions of their self-efficacy for participating in the treatment decision, and their preferred treatment options should they receive a diagnosis of localized prostate cancer.

Based on previous research, we predict that one-third of our participants will be diagnosed with early stage prostate cancer. These participants continue in our study, where we audio record their encounters with their urologists and/or radiation oncologists when they discuss options for treating their prostate cancer. Following the clinical visits, we conduct a third survey (S3) eliciting patientsí perceptions of doctor-patient interactions and of the decision making process.

Finally, we survey prostate cancer patients 6 months post-diagnosis (S4), to assess their ultimate treatment decisions and their long-term attitudes toward their prostate cancer decision making processes.

Discussing the Choice

09/01/2008 - 08/31/2013


National Cancer Institute

Principal Investigators:

Angela Fagerlin, PhD
Peter A. Ubel, MD


James A. Tulsky, MD
John T. Wei, MD, MS