Evaluation of a Computer-Based Decision Aid for Promoting Informed Prostate Cancer Screening Decisions Among African American Men: iDecide

• Published in: American journal of health promotion 2019-02, Vol.33 (2), p.267-278
• Main Authors: Owens, Otis L., Felder, Tisha, Tavakoli, Abbas S., Revels, Asa A., Friedman, Daniela B., Hughes-Halbert, Chanita, Hébert, James R.
• Format: Article
• Language: English
• Subjects: Adult; African Americans; Age Factors; Aged; Attitude to Computers; Averages; Black or African American; Decision making; Decision Support Techniques; Early Detection of Cancer - methods; Health Knowledge, Attitudes, Practice; Health promotion; Health Promotion - methods; Humans; Intervention; Linear analysis; Male; Medical diagnosis; Medical screening; Men; Middle Aged; Patient Participation; Prostate; Prostate cancer; Prostate-Specific Antigen; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - ethnology; Self Efficacy; Socioeconomic Factors; South Carolina; Technology
• ISSN: 0890-1171; 2168-6602
• DOI: 10.1177/0890117118786866

Purpose: To evaluate the effects of iDecide on prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making among African American men. Design: One-group, pretest/posttest. Setting: Community settings in South Carolina. Participants: African American men, ages 40 years +, without a prior prostate cancer diagnosis (n = 354). Intervention: iDecide, an embodied conversational agent-led, computer-based prostate cancer screening decision aid. Measures: Prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making. Analysis: Descriptive statistics, paired t tests, general linear modeling, Spearman correlations. Results: On average, participants experienced significant improvements in their prostate cancer knowledge (P ≤ .001), informed decision-making self-efficacy (P ≤ .001), and technology use self-efficacy (P ≤ .001), postintervention. Additionally, 67% of participants reported an intention to engage in informed decision-making. Conclusion: Given the significant improvements across all measures, this research demonstrates that embodied conversational agent-led decision aids can be used to enhance the capacity for making informed prostate cancer screening decisions among African American men and increase their technology use self-efficacy. One critical limitation of this study is that most men had received prostate cancer screening prior to engaging in our intervention, so the implications of this intervention may be different for men who do not have a history of screening. Additionally, actual engagement in informed decision-making postintervention was not assessed.