An Adaptation, Extension and Pre-Testing of an Interactive Decision Aid for Men Diagnosed with Localized Prostate Cancer in Iceland: A Mixed-Method Study

• Published in: Behavioral medicine (Washington, D.C.) Vol. ahead-of-print; no. ahead-of-print; pp. 1 - 14
• Main Authors: Eiriksdottir, Valgerdur Kristin, Jonsdottir, Thordis, Valdimarsdottir, Heiddis B., Taylor, Kathryn L., Schwartz, Marc D., Hilmarsson, Rafn, Gudmundsson, Eirikur Orri, Fridriksson, Jon Orn, Baldursdottir, Birna
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 01.04.2023; Taylor & Francis Inc
• Subjects: Access; Aged; Aged, 80 and over; Cancer; Cancer therapies; Clinical research; Clinical trials; Coding; decision aid; Decision making; Decision Support Techniques; explicit values clarification; Humans; Iceland; Interviews; Layout; Literature reviews; localized prostate cancer; Male; Males; Men; Middle Aged; Mixed methods research; Newly diagnosed; Patients; Prostate; Prostate cancer; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - therapy; Radiation; Radiation therapy; Radiology; Randomized Controlled Trials as Topic; Review Literature as Topic; Semi Structured Interviews; Side effects; Social support; Surgery; Surveys and Questionnaires; Tests; treatment options; Usability; Values Clarification; Iceland; explicit values clarification; localized prostate cancer; decision aid; treatment options
• ISSN: 0896-4289; 1940-4026
• DOI: 10.1080/08964289.2021.2000926

In this study an interactive decision aid (DA) for men diagnosed with localized prostate cancer was adapted, extended and pre-tested. The DA's prototype was based on a literature review and other empirically tested DAs. Semi-structured interviews with 12 men (age 65-80) diagnosed with localized prostate cancer were conducted to get feedback on content, usability, and the DA's layout. The interviews were analyzed using thematic analysis and themes were identified using deductive and inductive coding. Participants found the accessibility of the information and the explicit values clarification tool helpful. Four themes were identified: (1) usability and design, (2) content and knowledge, (3) deciding factors of decision-making, and (4) social support. Participants valued receiving extensive and realistic information on surgery/radiation therapy side effects and getting unbiased presentations of treatment options. Following the thematic analysis, the DA was revised and tested in a survey among 11 newly diagnosed prostate cancer patients (age 60-74). The participants valued the DA and found it helpful when making a treatment decision, and all reported that they would recommend it to others making a prostate cancer treatment decision. The DA is currently being tested in a randomized clinical trial (RCT). This is the first DA developed for prostate cancer patients in Iceland and if the results of the RCT show that it is more effective than standard care in assisting newly diagnosed patients with their treatment decision, the DA can be easily translated and adapted to cultures similar to Iceland such as the Nordic countries.