Trial of Community Health Worker-led Decision Coaching

Percentage of participants who receive at least one PSA screening. Screening data are collected through patient self-reports and electronic health record data.

The Patient Knowledge Survey comprises 12 items assessing participants' understanding of PSA testing and prostate cancer. Respondents provide an answer of "True," "Unsure," or "False." The total score is the sum of correct responses and ranges from 0-12; higher scores indicate greater knowledge. This survey will be administered twice: once directly following the coaching session prior to the patient's appointment, and again following the appointment.

The Measure of Informed Choice Attitudes Survey comprises 4 questions assessing participants' attitudes toward PSA testing. Each item is rated on a scale from 1-7. The total score is the sum of responses (the third item is reverse-scored) and ranges from 4 to 28; lower scores indicate more positive attitudes toward PSA screening. This survey will be administered twice: once directly following the coaching session prior to the patient's appointment, and again following the appointment.

The Decision Quality survey includes 12 items assessing participants' attitudes toward prostate cancer treatment and screening. Each item is rated on a scale from 1-5, where 1 = strongly disagree and 5 = strongly agree. The total score is the sum of responses and ranges from 12 to 60; higher scores indicate more positive attitudes toward treatment and screening. This survey will be administered twice: once directly following the coaching session prior to the patient's appointment, and again following the appointment.

The Decision Self-Efficacy Scale is an 11-item survey measuring confidence in making an informed choice. Each item is rated on a scale from 0-4, where 0 = not at all confident and 4 = very confident. The total score ranges from 0 to 44; higher scores indicate greater confidence in making an informed choice.

The Doctor-Patient Communication Survey includes 19 items assessing how participants felt they were able to communicate with their provider. Each item is rated on a scale from 1-5, where 1 = strongly disagree and 5 = strongly agree. The total score is the sum of responses and ranges from 12 to 60; higher scores indicate greater doctor-patient communication. This survey will be administered twice: once directly following the coaching session prior to the patient's appointment, and again following the appointment.

PEPPI is a 10-item assessment of participant's perceived self-efficacy for communicating with their provider. Each item is rated on a scale from 1-5, where 1 = not at all confident and 5 = very confident. The total score is the sum of responses and ranges from 10 to 50; higher scores indicate greater self-efficacy in communicating with providers.

The Decisional Conflict Scale is a 16-item survey assessing the level of decisional conflict for participants when deciding whether to have prostate cancer screening. Each item is rated on a 0-4 scale, where 0 = strongly agree and 4 = strongly disagree. The total score is the sum of responses and ranges from 0 to 64; lower scores indicate lower levels of decisional conflict.

6-item assessment of participants' satisfaction with their prostate cancer screening decisions. Each item is rated on a 1-5 scale, where 1 = strongly disagree and 5 = strongly agree. Higher scores indicate greater satisfaction.

5-item assessment of participants' regret toward the first decision they made about prostate cancer screening after speaking with their provider. Each item is rated on a scale from 1-5, where 1 = strongly agree and 5 = strongly disagree. The total score is the sum of responses and ranges from 5 to 25; lower scores indicate lower levels of regret/greater satisfaction.