Trial Information

CD-ROM Intervention for Prostate Cancer Screening

The study populations consist of a sample of the patient population (men aged 40-79 years)
of a large, group model HMO and a community sample of men age 50-79. Follow-up interviews
of men randomly assigned to the intervention and control groups are being conducted by
telephone to assess issues related to prostate cancer screening and the men’s use of the
CD-Rom educational intervention. Preliminary results are available for the first 1304
follow-up interviews (interim response rate = 26%). Of 554 men randomized to receive the
CD-ROM, 227 (41%) reported receiving the CD-ROM, and 78 (14%) used it in a computer. About
51% of these 78 men used the CD-ROM once only, while 42% used it twice, and 27% shared it
with someone else. Most users reported learning some (44%) or a great deal (46%) of new
information from the CD-ROM, and most reported that it helped them organize their thoughts
about screening somewhat (44%) or a great deal (28%). About 19% indicated that the CD-ROM
increased their uncertainty somewhat or a great deal about whether or not they want to be
screened, 30% reported that the CD-ROM changed their feelings about whether or not they want
to be screened somewhat, and 12% reported that it changed their feelings a great deal. Men
who used the CD-ROM had higher education, higher income, higher levels of computer usage,
and were more likely to have previously had a PSA test compared to non-users. No other
subject characteristics were significantly related to use. Using randomized group
assignment in an “intention to treat” analysis, prostate cancer knowledge was significantly
higher in the intervention group; there were no differences between study groups in
decisional conflict or realistic expectations. However, when comparing those who did and
did not use the CD-ROM using multiple regression analysis and controlling for differences in
age, race, education, income, insurance status, previous receipt of prostate cancer
screening, and computer usage, use of the CD-ROM was significantly associated with higher
prostate cancer related knowledge, lower decisional conflict, and more realistic
expectations about risk of dying from prostate cancer. After controlling for differences
between users and non-users we found evidence that the CD-ROM was effective in reducing
decisional conflict, and increasing knowledge and realistic expectations related to prostate
cancer screening.