PURPOSE: Evaluate the implementation of a decision support intervention by community-based cancer resource centers in two rural, underserved counties of California. METHODS: The leaders of cancer resource centers in Humboldt and Mendocino counties requested that UCSF train 8 staff and 2 peer navigators in Consultation Planning (CP), an intervention that documents the patient agenda prior to a visit with a medical specialist. These counties are federally-designated Medically Underserved and have 6 and 5% Native American, 6 and 17% Hispanic, and 20 and 16% under the poverty line, respectively. We evaluated whether the CP intervention was implemented with high fidelity, and whether it was as satisfying to rural patients as to the urban academic medical center patients of a prior study. Our primary measure was the Satisfaction with Visit Preparation scale (alpha = 0.71), which had previously distinguished between CP (6.4/10) and an active listening control (6.4 versus 3.9, p<0.001, see Journal of Clinical Oncology, Vol. 20, Issue 11). The present evaluation had 80% power to detect an increase in the proportion of patients rating CP at 8/10 or better, compared to CP patients in the prior study. We analyzed resource center records from the calendar year 2003. Due to the non-normality of the satisfaction data in the prior study, we used ordered logistic regression to assess the change in SVP scores. RESULTS: The resource centers had complete records for 67 of 132 patients that received CP in 2003. Their mean satisfaction was significantly higher than at the academic medical centers (8.4 versus 6.4, p<0.001). 45/67 (67%) rated CP at better than 8/10, compared to 17/42 (40%) in the prior study (p<0.05). 40 breast cancer patients were significantly more satisfied than 27 patients with other cancers (9.3 versus 7.8, p=0.003), as were 59 women compared to 8 men (8.8 versus 7.4, p<0.05). Patients were equally satisfied with staff or volunteer peer navigators (p=0.89). The printed Consultation Plans reflected 100% compliance with the core CP training strictures, which require trainees to elicit patient questions or concerns in each of six decision topic areas and prohibit trainees from providing medical advice or information. CONCLUSIONS: For CP, translating decision research into practice with a new population has resulted in an increased level of satisfaction.