Do Interventions Designed to Support Shared Decision-Making Reduce Health Inequalities? A Systematic Review and Meta-Analysis
OBJECTIVES This feasibility study developed and pilot tested an intervention to: (1) increase knowledge about prostate cancer screening; and (2) promote self-efficacy to participate in the informed decision-making process. SETTING African American men are a priority audience for prostate cancer screening interventions to promote informed decision making, and faith-based settings have been shown to be an effective venue to reach this population. Therefore we used predominantly African American churches to develop and test our intervention. PARTICIPANTS Participants (N = 73) were recruited, and the intervention was administered by an African American health educator. INTERVENTION We developed and pretested a prostate cancer screening informed decision-making intervention based on the Ottawa Decision Support Framework and the health belief model. The intervention included a tool called the "road map," which depicts the potential consequences of a decision to undergo or forgo screening. A quasiexperimental design was used to test the intervention. MAIN OUTCOME MEASURES The main outcome measures were change in knowledge and self-efficacy post intervention. RESULTS Prostate cancer knowledge (p < .0001) and self-efficacy (p = .025) significantly increased. CONCLUSIONS A church-based intervention delivered by an African American health educator is a promising strategy for promoting informed decision making among African American men.