This project aims to develop and test new materials that involve patient decision-making. The topic addresses prostate cancer, treatment options and outcomes. We will revise a paper-based decision aid and develop alternative media formats (audiotape- and Internet-based versions) of the paper based decision aid to increase distribution and utilization. We will also test the paper, audiotape, and Internet-based decision aids in an appropriate population of patients to provide pilot data on the tools' efficacy for improving patient knowledge.

prostate cancer, decision aid, patient knowledge, print, Internet, web, audiotape

1. Create a complementary audiotape-based version of the Phase II, paper-based decision aid covering the same content materials.
   
2. Create a complementary Internet-based version of the Phase II decision aid covering the same content materials.
3. Test the paper, audiotape, and Internet-based decision aids in an appropriate population of patients to provide pilot data on the tools' efficacy for improving patient knowledge, decisional conflict, and satisfaction with the new materials.

60 men, newly diagnosed with prostate cancer, located in Michigan.

Men newly diagnosed with prostate cancer in the State of Michigan are recruited from the University of Michigan, Wayne State University and Henry Ford Hospital and other clinics. Men receive one of the three prostate cancer treatment decision aids: print booklet, audiotape, or website. When men come in for their initial consultation following their biopsy, they are asked to select the decision aid (print, audiotape, or Internet) they desire. Once 20 men have chosen a format, that format is no longer an option. The participant's chosen decision aid is mailed via 2nd day mail with instructions on their use.

One to two weeks after the mailing, the participants are interviewed via telephone to assess:

1. their knowledge of prostate cancer, its treatment options and outcomes
2. patients' self-efficacy for making their treatment decisions and their experience with decisional conflict
3. patients' satisfaction with the shared decision making education material they chose

• Formative evaluation among newly diagnosed prostate cancer patients found the decision aid to be clear and useful in reaching a decision.
• Newly diagnosed patients reported more discussions with doctors about treatment options, and showed increases in knowledge of side effects of radiation therapy.

The plain language decision aid presenting medical evidence in text and numerical formats appears acceptable and useful in decision-making about localized prostate cancer treatment. Further testing should evaluate the impact of all three media on decisions made and quality of life in the survivorship period, especially among very low literacy men.

Fagerlin, A., Rovner, D., Stableford, S., Jentoft, C., Wei, J. T., and Holmes-Rovner, M.: Patient education materials about the treatment of early-stage prostate cancer: a critical review. Annals of Internal Medicine 140(9):721-8, 2004.<br><br>

Holmes-Rovner M, Stableford S, Fagerlin A, Wei JT, Dunn RL, Ohene-Frempong J, Kelly-Blake K, Rovner DR. Evidence-based patient choice: a prostate cancer decision aid in plain language. BMC Med Inform Decis Mak. 2005 Jun 20;5(1):16.