Information and patient participation in screening for prostate cancer. Encouraging young males to perform testicular self-examination: a simple, but effective, implementation intentions intervention. The Impact of a Self-Help Pamphlet on Reducing Risk Drinking Among 30- to 49-Year-Old Men in Helsinki, Finland A randomized controlled trial comparing internet and video to facilitate patient education for men considering the prostate specific antigen test Randomized trial examining the effect of two prostate cancer screening educational interventions on patient knowledge, preferences, and behaviors Randomised control trial of a smoking cessation intervention directed at men whose partners are pregnant. Preparing African-American men in community primary care practices to decide whether or not to have prostate cancer screening. Does the type of promotional material influence men's attendance at skin screening clinics? Adherence by African American men to prostate cancer education and early detection Patient Education for Informed Decision Making About Prostate Cancer Screening: A Randomized Controlled Trial with 1-Year Follow-Up Educating men about prostate cancer screening. A randomized trial of a mailed pamphlet. The importance of patient preference in the decision to screen for prostate cancer A 2-year self-help smoking cessation manual intervention among middle-aged Finnish men: an application of the transtheoretical model. A frequently used patient and physician-directed educational intervention does nothing to improve primary care of prostate conditions. A community-based randomised controlled trial of three different educational resources for men about prostate cancer screening. The effect of an illustrated pamphlet decision-aid on the use of prostate cancer screening tests. A randomized controlled trial of shared decision making for prostate cancer screening.
The purpose of this study was to determine if providing men with information about screening for prostate cancer would enable them to assume a more active role in decision making with their family physician , and lower levels of anxiety and decisional conflict .  Men were recruited from one family medical clinic in Winnipeg , Manitoba . One hundred men scheduled for a periodic health examination ( PHE ) were r and omly assigned to receive verbal and written information either prior to the PHE , or following the second interview . Men completed measures of preferred decisional role and anxiety prior to the PHE ; and assumed decisional role , decisional conflict , and anxiety post PHE . Results demonstrated that men who received the information prior to the PHE assumed a significantly more active role in making a screening decision , and had lower levels of decisional conflict post PHE . The two groups did not differ with regard to levels of state anxiety . Providing men with information enables them to make informed screening decisions with their family physicians OBJECTIVES The objective of this study was to examine the effectiveness of a simple psychological intervention known as ' implementation intentions ' to promote performance of testicular self-examination ( TSE ) in a sample of young males . METHOD A prospect i ve , r and omized controlled design measured knowledge of testicular cancer , prior experience with TSE and intention to perform TSE within a 3-week period . Participants in the intervention group were instructed to formulate specific plans for when and where they would perform TSE . Three weeks later , a second question naire assessed self-reported performance of TSE during the study period and future intention to perform TSE .  One hundred and fifty-nine male undergraduates aged between 18 and 35 were assigned , at r and om , to an intervention or non-intervention group .  Men over 35 were excluded so that the sample reflected the highest risk age group for testicular cancer . Just under half the original participants ( 76/159 ) completed the study . We measured performance of TSE and future intention to perform TSE . RESULTS Responders and non-responders did not differ on any of the measures assessed at Time 1 . At Time 2 , 30 ( 65 % ) participants in the intervention reported performing TSE compared with 12 ( 40 % ) in the control condition , and chi-squared analyses revealed that the difference was significant . CONCLUSIONS The implementation intentions intervention procedure , which encourages the use of environmental and context ual ' cues ' to prompt a desired behaviour , appears to offer a promising strategy for encouraging the performance of TSE This study evaluates the impact of a self-help pamphlet design ed to support self-control of drinking . It was conducted in Helsinki , Finl and , in 2001 and 2002 and focused on men between 30 and 49 years of age . The respondents were r and omly selected in an intervention and a control area and compared with each other before and after the intervention using independent sample s ( N = 4418 ) The results support previous findings showing that interventions like this serve as a supplement to other prevention and early treatment measures . Although the results were encouraging , there is a need for more in-depth studies in the field Abstract BACKGROUND : Little is known about the relative advantages of video versus internet-based decision aids to facilitate shared medical decision making . This study compared internet and video patient education modalities for men considering the prostate specific antigen ( PSA ) test . METHODS : Two hundred and twenty-six men , aged 50 years or older , and scheduled to complete a physical examination at an HMO Health Appraisal Clinic were r and omly assigned to access a website ( N=114 ) or view a 23-minute videotape in the clinic ( N=112 ) prior to deciding whether they wanted to be screened for prostate cancer . RESULTS : There were no between-groups differences in participants ’ ratings of convenience , effort , or satisfaction following exposure to the decision aid . Participants assigned to the video group were more likely to review the material s than individuals assigned to the internet group ( 98.2 % vs 53.5 % ) . Participants in the video group showed significantly greater increases in PSA knowledge and were more likely to decline the PSA test than individuals assigned to the internet group . However , participants in the internet group who review ed the entire online presentation showed similar increases in PSA knowledge as video participants . Only 5 % of all participants visited other websites to inform themselves about the PSA test . CONCLUSIONS : Overall , the video was significantly more effective than the Internet in educating participants about benefits and risks of PSA screening Abstract OBJECTIVE : To assess the effect of video and pamphlet interventions on patient prostate cancer ( CaP )  screening knowledge , decision-making participation , preferences , and behaviors . DESIGN : R and omized , controlled trial . SETTING : Four midwestern Veterans Affairs medical facilities . PATIENTS / PARTICIPANTS : One thous and , one hundred fifty-two male veterans age 50 and older with primary care appointments at participating facilities were r and omized and 893 completed follow-up . INTERVENTIONS : Patients were r and omized to mailed pamphlet , mailed video , or usual care/control . MEASUREMENTS AND MAIN RESULTS : Outcomes assessed by phone survey 2 weeks postintervention included a 10-item knowledge index ; correct responses to questions on CaP natural history , treatment efficacy , the prostate-specific antigen ( PSA ) ’s predictive value , and expert disagreement about the PSA ; whether screening was discussed with provider ; screening preferences ; and PSA testing rates . Mean knowledge index scores were higher for video ( 7.44 ; P=.001 ) and pamphlet ( 7.26 ; P=.03 ) subjects versus controls ( 6.90 ) . Video and pamphlet subjects reported significantly higher percentages of correct responses relative to controls to questions on CaP natural history ( 63 % , 63 % , and 54 % , respectively ) ; treatment efficacy ( 19 % , 20 % , and 5 % ) , and expert disagreement ( 28 % , 19 % , and 8 % ) , but not PSA accuracy ( 28 % , 22 % , and 22 % ) . Pamphlet subjects were more likely than controls to discuss screening with their provider ( 41 % vs 32 % ; P=.03 ) but video subjects were not ( 35 % ; P=.33 ) . Video and pamphlet subjects were less likely to intend to have a PSA , relative to controls ( 63 % , 65 % , and 74 % , respectively ) . PSA testing rates did not differ significantly across groups . CONCLUSIONS : Mailed interventions enhance patient knowledge and self-reported participation in decision making , and alter screening preferences . The pamphlet and video interventions evaluated are comparable in effectiveness . The lower-cost pamphlet approach is an attractive option for clinics with limited re sources BACKGROUND Although smoking cessation programs significantly reduce smoking rates in the general population , some sectors are poorly motivated by them , especially healthy men from lower socioeconomic classes . METHODS By using a significant life event ( approaching birth of a child ) we exploited a time of increased receptiveness to smoking cessation influences . A multicomponent intervention was conducted and evaluated using a stratified , r and omised control trial , with an intention to treat analysis . RESULTS Five hundred and sixty-one men were enrolled and 505 ( 90 % ) followed to the end of their partners ' pregnancy . At 6-month follow-up 16.5 % of 291 smokers of the intervention group and 9.3 % of 270 in the control group reported they had stopped smoking ( P=0.011 , OR=0.52 , 95 % CI 0.31 - 0.86 ) . The strongest predictors of smoking cessation were being in a skilled occupation , having a higher number of quit attempts in the previous year and having the first cigarette of the day relatively later . CONCLUSIONS The number of smoking men who had to be treated to achieve one stopping smoking ( NNT ) during their partner 's pregnancy was 13 to 14 . Innovative antismoking population health measures for the partners of antenatal patients are effective and perhaps should be more widely adopted BACKGROUND This study was a r and omized trial to test the impact of an informed decision-making intervention on prostate cancer screening use . METHODS The study population included 242 African-American men from three primary care practice s who were 40 - 69 years of age and had no history of prostate cancer . Participants completed a baseline survey question naire and were r and omly assigned either to a St and ard Intervention ( SI ) group ( N=121 ) or an Enhanced Intervention ( EI ) group ( N=121 ) . An informational booklet was mailed to both groups . EI group men were also offered a screening decision education session . Two outcomes were considered : ( 1 ) complete screening ( i.e. , having a digital rectal exam ( DRE ) and prostate specific antigen ( PSA ) testing ) , and ( 2 ) complete or partial screening ( i.e. , having a PSA test with or without DRE ) . An endpoint chart audit was performed six months after initial intervention contact . The data were analyzed via exact logistic regression . RESULTS Overall , screening use was low among study participants . EI group men had a screening frequency two times greater than that of SI group men , but the difference was not statistically significant : 8 % vs. 4 % ( OR = 1.94 ) fo rcomplete screening , and 19 % vs. 10 % ( OR = 2.08 ) for complete or partial screening . Multivariable analyses showed that being in the EI group and primary care practice were significant predictors of complete or partial screening ( OR = 3.9 and OR = 5.64 , respectively ) . CONCLUSION Prostate cancer screening use may be influenced by exposure to decision education and the influence of screening-related primary care practice factors ISSUE ADDRESSED The incidence of skin cancer is rising in many population s around the world . In Australia , men have both the highest incidence of thick melanoma and an increased risk of dying from this disease . Skin screening may provide a method for detecting lesions at an earlier stage . This study sought to assess the impact of two methods of encouraging men to attend free open-access skin screening clinics . METHODS A r and omised controlled trial of two recruitment methods . Subjects comprised all men aged 30 to 79 years ( n=1,322 ) from a rural community . We r and omly allocated 50 % ( 661 ) to receive a personalised letter with the remaining 50 % receiving the letter plus an additional brochure . RESULTS Both groups were similar in age distribution . A total of 250 men ( 18.9 % ) attended the skin screening clinic . Overall , there was no difference in rates of attendance between the two groups . Younger men ( 30 to 49 years ) in the letter and brochure group were more likely to attend a clinic , while men > or = 50 years in the letter only group were more likely to attend ( p=0.01 ) CONCLUSIONS These results indicate that a personalised letter or targeted approach of invitation is effective in encouraging men to attend a skin screening clinic . The addition of health information through the use of a glossy brochure did not increase screening participation among men over 50 This study was design ed to identify factors that predict adherence by African American men to prostate cancer education and early detection PURPOSE The efficacy of prostate cancer screening is uncertain , and professional organizations recommend educating patients about potential harms and benefits . We evaluated the effect of a videotape decision aid on promoting informed decision making about prostate cancer screening  among primary care patients . METHODS A group of 160 men , 45 to 70 years of age , with no history of prostate cancer , were r and omized to view or not to view a 20-minute educational videotape before a routine office visit at a university-based family medicine clinic . The subjects were contacted again 1 year after their visit to assess their receipt of prostate cancer screening ( digital rectal examination [ DRE ] or prostate-specific antigen [ PSA ] testing ) , their satisfaction with their screening decision , and knowledge retention since the baseline assessment . RESULTS Follow-up assessment s were completed for 87.5 % of the intervention subjects and 83.8 % of the control subjects . The rate of DRE did not differ between the 2 groups . Prostate-specific antigen testing was reported by 24 of 70 ( 34.3 % ) intervention subjects and 37 of 67 ( 55.2 % ) control subjects ( P = .01 ) . African American men were more likely to have had PSA testing ( 9 of 16 , 56.3 % ) than were white men ( 13 of 46 , 28.3 % ) ( P = .044 ) . Satisfaction with the screening decision did not differ between the study groups . Intervention subjects were more knowledgeable of prostate cancer screening than were control subjects , although these differences declined within 1 year ( P < .001 ) . CONCLUSIONS Decision aids for prostate cancer screening can have a long-term effect on screening behavior and appear to promote informed decision making CONTEXT Although evidence -based guidelines recommend that physicians inform men about prostate cancer screening , the most efficient way to do this is not known . OBJECTIVE To evaluate whether a mailed educational pamphlet affected men 's knowledge about early detection of prostate cancer . DESIGN R and omized , controlled trial . SETTING Primary care clinic of the Minneapolis VA Medical Center . PATIENTS 342 men at least 50 years of age who responded to a mailed survey ( overall response rate , 68 % ) and did not report a history of prostate cancer . INTERVENTION " Early Prostate Cancer " pamphlet mailed to patients in the intervention group 1 week before their scheduled clinic appointments . OUTCOME MEASURES Patients ' responses to a survey mailed 1 week after their clinic appointments ; prostate-specific antigen ( PSA ) testing determined from electronic medical records . RESULTS Respondents were predominantly elderly white men ( mean age , 71 years ; 90 % white ) with chronic illnesses ( 48 % described their health as " fair " or " poor " ) . Men who received the educational pamphlet were better informed than men in the usual care group , as measured by correct responses to the following three questions about prostate cancer screening : the natural history of prostate cancer ( 32 % vs. 24 % ; P = 0.10 ) , whether treatment lengthens lives of men with early prostate cancer ( 56 % vs. 44 % ; P = 0.04 ) , and accuracy of PSA testing ( 46 % vs. 27 % ; P < 0.008 ) . The overall proportion of correctly answered questions was greater in the intervention group ( 45 % vs. 32 % ; P < 0.001 ) . Testing for PSA in the year after the index clinic appointments did not differ significantly between the intervention group and the usual care group ( 31 % vs. 37 % ; P > 0.2 ) . CONCLUSIONS Male veterans are poorly informed about the potential benefits and risks of prostate cancer screening . Although our mailed educational pamphlet enhanced knowledge only modestly , it was an inexpensive and easily implemented intervention Abstract OBJECTIVE : Routine screening for prostate cancer is controversial because of frequent false-positive results , the potential for slow , non-life-threatening growth of untreated cancer , the uncertainty regarding whether treatment can extend life , and the potential for treatment complications . This study examines how information about prostate-specific antigen ( PSA ) testing and the uncertain benefits of treating prostate cancer affects patients ’ desire for PSA testing . DESIGN : An educational videotape design ed to inform men about the uncertainty surrounding PSA screening and the treatment of early-stage prostate cancer was presented to two groups of male patients 50 years of age or older . SETTING : Dartmouth-Hitchcock Medical Center . PATIENTS / PARTICIPANTS : For study 1 , men seeking a free prostate cancer screening were preassigned to view the educational videotape ( N=184 ) or another videotape ( N=188 ) . For study 2 , men scheduled to visit a general internal medicine clinic viewed either the educational videotape ( N=103 ) or no videotape ( N=93 ) . MEASUREMENTS AND MAIN RESULTS : The men ’s information and preferences about prostate cancer screening and treatment and actual choice of PSA test at the next test opportunity were measured . Men who viewed the educational videotape were : better informed about PSA tests , prostate cancer , and its treatment ; preferred no active treatment if cancer were found ; and preferred not to be screened ( all significant atp≤.002 in both studies ) . Men viewing the educational video were less likely to have a PSA test ( p=.041 , study 2 ) . This tendency was not significant at the free-PSA clinic ( p=.079 ) . CONCLUSIONS : Preference regarding cancer screening and treatment is greatly affected by information about medical uncertainties . Because informed patient choices vary , PSA screening decisions should incorporate individual preferences BACKGROUND A 2-year self-help manual smoking cessation intervention was conducted among a panel of middle-aged Finnish men ( n = 265 ) who were recruited proactively in a longitudinal cardiovascular risk factor surveillance study . METHODS Intervention utilized the stages of change concept of the transtheoretical model . The stages were assessed in the treatment condition at baseline of the cessation study and after that by mail every sixth month . Assessment s were followed by an immediate mailing of a stage-based self-help manual matching the stage of change at that time . A usual care group was assessed annually but received no treatment . RESULTS A significant time x intervention effect ( P < 0.05 ) and time x baseline stage effect ( P < 0.001 ) on quit rates were observed in the panel data over the 2-year period . An analysis of changes in the stages of change also revealed an accelerated cessation process in the treatment condition . CONCLUSIONS We conclude that mailed stage-matched self-help smoking cessation manuals were able to accelerate the smoking cessation process but manuals alone may not constitute a sufficient long-term intervention . The effects of differential exposure to intervention , subject characteristics , measurement reactivity , and secular trends are discussed as potential confounds OBJECTIVES To measure the impact of an educational intervention directed at both patients and their primary care physicians about prostate-related conditions . METHODS We used a r and omized , control design for 50 physicians in 33 rural primary care practice s from New Engl and and Arkansas and a probability sample of 2402 of their male patients . For the physicians , we mailed two newsletters , conducted two face-to-face research staff visits , and provided printed educational manuals about the management of prostate conditions . For the patients , mailed educational pamphlets were targeted to the baseline symptom levels . After 18 months , 87 % of patients and 92 % of physicians completed a final survey . The patient survey measured health status , urinary symptoms and bother , treatments received , and prostate-related knowledge . The final physician survey asked them about their management of common prostate conditions . RESULTS Before r and omization , most men ( 59 % ) said they knew little or nothing about prostate problems that affect urination , and 63 % also reported " little " or " no " knowledge about prostate-specific antigen testing . Eighteen months later , we observed no differences between the intervention and control patients in the measures of health status , urinary symptoms and bother , treatments received , and prostate-related knowledge . The intervention , physicians ' knowledge , and self-reported practice s for managing common prostate conditions were no better than the control physicians ' . CONCLUSIONS This commonly used education strategy had no measurable impact on prostate-related care R and omised evaluations of re sources to facilitate informed decisions about prostate cancer screening are rarely conducted . In this study , 421 men recruited from the community were r and omly allocated to receive a leaflet ( n = 140 ) or one of two re sources meeting criteria for a decision-aid : a video ( n = 141 ) or an evidence -based booklet , developed by the authors ( n = 140 ) . Men in all three groups demonstrated significant increases in knowledge scores from pre to post-test . Scores were significantly higher at post-test amongst those who had received our evidence -based booklet compared with men who received the leaflet or video ( P < 0.001 ) . Scores were significantly modified by men 's preferences for decisional control ( P = 0.002 ) . Decisional conflict was significantly lower amongst men receiving the evidence -based booklet ( P = 0.038 ) . Men receiving the evidence -based booklet also were less likely to accept a recommendation by a GP to undergo prostate-specific-antigen ( PSA ) screening ( P = 0.003 ) . Men require detailed information about the pros and cons of PSA screening in order to make an informed decision . Re sources are not equivalent in achieving these outcomes BACKGROUND Prostate cancer screening with serum prostate-specific antigen ( PSA ) and digital rectal examination ( DRE ) continues to increase . Our goal was to test the effect of a prostate cancer screening decision-aid on patients ' knowledge , beliefs , and use of prostate cancer screening tests . METHODS Our study was a r and omized controlled trial of a prostate cancer screening decision-aid consisting of an illustrated pamphlet as opposed to a comparison intervention .  We included 257 men aged 50 to 80 years who were receiving primary care at a Department of Veterans Affairs Hospital in Milwaukee , Wisconsin . The decision-aid provided quantitative outcomes of prostate cancer screening with DRE and PSA . We subsequently evaluated prostate cancer screening knowledge , beliefs , and test use . RESULTS The illustrated pamphlet decision-aid was effective in improving knowledge of prostate cancer screening tests : 95 % of the experimental group were aware of the possibility of false-negative test results compared with 85 % of the comparison group ( P < .01 ) . Ninety-one percent of the experimental group were aware of the possibility of a false-positive screening test result compared with 65 % of the comparison group ( P < .01 ) . However , there was no difference in the use of prostate cancer screening between the experimental ( 82 % ) and comparison ( 84 % ) groups , ( P > .05 ) . CONCLUSIONS When used in a primary care setting , an illustrated pamphlet decision-aid was effective in increasing knowledge of prostate cancer screening tests but did not change the use of these tests OBJECTIVE To evaluate a patient-educational approach to shared decision making for prostate cancer screening . DESIGN R and omized controlled trial with preoffice visit assessment and 2-week follow-up . SETTING University-based family practice center . PATIENTS Men aged 45 through 70 years with no history of prostate cancer or treatment for prostate disease ( N = 160 ) . Two patients were unavailable for follow-up . INTERVENTION Twenty-minute educational videotape on advantages and disadvantages of prostate-specific antigen ( PSA ) screening for prostate cancer . MAIN OUTCOME MEASURES A measure of patients ' core knowledge of prostate cancer developed for this study , reported preferences for PSA testing , and ratings of the videotape . RESULTS Patients '  core knowledge at baseline was poor . At 2-week follow-up , subjects undergoing videotape intervention showed a 78 % improvement in the number of knowledge questions answered correctly ( P = .001 ) , and knowledge increased about mortality due to early-stage prostate cancer , PSA screening performance , treatment-related complications , and disadvantages of screening . No overall change was observed for control subjects . At follow-up , 48 ( 62 % ) of 78 intervention patients planned to have the PSA test compared with 64 ( 80 % ) of 80 control patients ( 18.5 % absolute reduction ; 95 % confidence interval , 4.6%-32.4 % ; P = .009 ) . Intervention subjects rated favorably the amount of information provided and the clarity , balance , and length of the videotape and would recommend the videotape to others . CONCLUSIONS Patient education regarding the potential benefits and harms of early detection of prostate cancer can lead to more informed decision making . Incorporating the PSA videotape into the periodic health examination for asymptomatic men aged 50 years and older is recommended
Background Encouraging men to make more effective use of ( preventive ) health services is considered one way of improving their health .
The aim of this study was to appraise the available evidence of effective interventions aim ed at improving men 's health .
Conclusion Most of the existing evidence relates to male sex-specific health problems as opposed to general health concerns relevant to both men and women .
There is little published evidence on how to improve men 's uptake of services .