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Helping Men Decide About Scheduling a Prostate Cancer Screening Exam

Department of Management and Operations, Villanova School of Business, Villanova University, Villanova, Pennsylvania 19085
Department of Management and Operations, Villanova School of Business, Villanova University, Villanova, Pennsylvania 19085
Department of Pharmacology and Experimental Therapeutics, Division of Biostatistics, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
Department of Psychiatry and Human Behavior, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
Department of Medical Oncology, Division of Population Science, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
matthew.liberatore{at}villanova.edu
robert.nydick{at}villanova.edu
c.daskalakis{at}mail.jci.tju.edu
elisabeth.kunkel{at}mail.tju.edu
james.cocroft{at}jefferson.edu
ron.myers{at}mail.tju.edu

This paper reports on the application of decision counseling based on the analytic hierarchy process (AHP) to assist men in deciding whether or not to schedule a prostate cancer screening exam. The study is based on data that we collected from 129 men enrolled in the intervention arm of two randomized, controlled trials. First, we administered a baseline survey to gather data on participant sociodemographic characteristics and perceptions about prostate cancer and screening. Subsequently, a health educator conducted a session with each man to review an informational booklet on prostate cancer screening. Then, the health educator used an AHP-based decision process that identified the most important factors (both pro or con) that might influence prostate cancer screening preferences, clarified preferences related to scheduling a prostate screening exam, and elicited a scheduling decision. We performed univariable and multivariable logistic regression analyses to identify variables associated with the decision. Of the 129 men enrolled, 85 men (66 percent) decided to schedule a prostate cancer screening exam. Multivariable analyses showed that preference strengths and favorable perceptions of prostate cancer screening predicted the decision to screen.

Key Words: decision making; decision-support techniques; analytic-hierarchy process; mass screening; randomized controlled trial