ASPO Abstracts
Patient Decision Aids, Knowledge and Control Preference for Decision Making Among Lung Cancer Screening-Eligible Individuals: A Pilot Study
Category: Behavioral Science & Health Communication, Early Detection & Risk Prediction
Conference Year: 2018
Abstract Body:
Purpose: Shared decision-making with the use of one or more patient decision aids (ptDA) is mandated by Medicare in the US for reimbursement of lung screening. However, we do not know the control preference for decision-making (patient-centered, shared, clinician-directed) among screening-eligible individuals or type of ptDA individuals prefer in the context of lung screening. It is critical to understand individual control preference, preference for ptDA, and preference for whom individuals would like to engage in a screening discussion to tailor interventions and foster engagement in this high-risk population. Methods: Cross-sectional, descriptive pilot study using survey methodology and web-based recruitment methods conducted with 51 lung screening-eligible individuals measuring control preference, sociodemographic variables, health literacy, numeracy, patient- clinician communication, knowledge about lung cancer and screening, ptDA preference (pamphlet, video, tailored computerized education), clinician preference (physician, nurse, advanced practice provider, team of professionals), and stage of adoption for lung screening. Results: Participant mean age was 60.2 years (SD4.7); majority were female (60.8%) and White (72.5%). Most noted a patient- centered control preference for decision making (n=31,60.8%) compared to shared (n=17,33.3%). Total knowledge scores were low (mean=3.61;SD1.5; range 0-9). Higher levels of patient-clinician communication were positively correlated with numeracy (r=.329;p=.02). Most participants preferred a tailored computerized education module (n=33;64.7%), and preferred to discuss the option of lung screening with either a doctor (n=30;58.8%) or advanced practice provider (i.e., NP/PA) (n=10;19.6%). Conclusions: Results indicate initial differences in control preference for decision making in lung screening as well as potential preference for different types of decision support in both tools and individual delivering the education. Future research with a larger sample size is warranted to examine the influence of control preference on engagement in patient-clinician discussions around lung screening as well as types of decision support and clinicians most effective in supporting in patients this decision-making process.
Keywords: shared decision making, control preference, lung cancer screening, health communication