LAUSR

Introduction: Decision aids for prostate cancer screening can increase knowledge and shared decision making, but remain underused due to cost and time constraints that disrupt clinic flow. We examined the impact of a simple prostate specific antigen screening decision aid distribution strategy on clinic flow as well as shared decision making in a diverse, urban primary care clinic. Methods: Men 50 to 75 years old viewed the decision aid while waiting for physicians. Participants and physicians completed questionnaires evaluating the shared decision making process. Focus groups were conducted with clinic staff and physicians to evaluate the impact on clinic operations. Results: Overall 50% of men discussed prostate specific antigen screening and 85% reported the decision aid made decision making easier. Participants reported an average of 12.9 minutes reading the decision aid, with high decision satisfaction and low decisional conflict. Physicians reported an average of 5.2 minutes discussing prostate specific antigen screening. Clinic staff reported increased enthusiasm for the process after adjustments were made in response to concerns including time, as well as lack of knowledge about the decision aid subject matter and involvement in the process. Physician reported barriers included ambivalence about prostate specific antigen screening. Conclusions: A prostate specific antigen screening decision aid, requiring few resources, can be implemented with broad involvement of clinic staff and minimal disruption to clinic flow in an urban primary care clinic, and may facilitate shared decision making.