Purpose: To determine the effect of a targeted decision aid (DA) on subjective and objective knowledge, willingness to participate, self efficacy, and preparedness to make decisions regarding participation in cancer clinical trials (CCTs) in Hispanic and Black cancer survivors.
Method: We developed a web-based DA based on a telephone survey (n=1100) and semi-structured interviews (n=45) with cancer survivors. The DA includes components to i) improve knowledge, ii) empower communication and information gathering, and iii) clarify values concerning participation in CCTs. Objective and subjective knowledge, willingness to participate, preparedness for decision-making , and information seeking were measured pre and post DA viewing using 7 point scales. Self-efficacy was measured by a 4 item instrument (5 point scale, post viewing only).
Result: To date, data have been collected and analyzed for 50 English speaking Blacks (n=35) and Hispanics (n=15) in South Florida (final target 100 English and 30 Spanish speaking participants); 47 female and 3 male cancer survivors. Willingness to participate and subjective knowledge scores pre and post viewing DA were as follows: Willingness to participate in CCTs: 5.96±1.60 → 6.12±1.33; NS. Self-rating of knowledge of CCTs: 4.26±1.69 → 6.30±0.89; p<0.0001. The percentage of individuals responding correctly to the 11 objective knowledge questions varied from 14% to 86% prior to viewing the DA, with a mean of 6.98±1.96 correct. Following viewing the DA, this changed to 26% to 98% correct, and a mean of 8.70±1.79 correct; p<0.0001. Measures of decision-making preparedness increased significantly after viewing the DA. Feeling prepared to make decision: 5.57±1.51 → 6.35±0.83; p<0.0001. Ability to seek information on CCT: 5.90±1.34 → 6.60±0.88; p<0.0001. Opinions clear in mind: 5.33±1.56 → 6.58±0.58; p<0.0001. The 4 item self-efficacy measure post viewing the DA was high: 19.29±1.21 (possible range 5-20).
Conclusion: We found that a targeted DA increased subjective and objective knowledge about participation in CCT as well as feeling of being prepared to make a decision about participation in a CCT. Use of this DA in a clinical setting may substantially increase informed decision making for participation in CCTs. Also, by improving self-efficacy, cancer patients will have the ability to approach healthcare providers about participation and thus the barrier of providers not offering trials to all appropriate patients will be reduced.
See more of: The 34th Annual Meeting of the Society for Medical Decision Making