Trial Outcomes & Findings for Trial of Community Health Worker-led Decision Coaching (NCT NCT03726320)

NCT ID: NCT03726320

Last Updated: 2024-05-23

Results Overview

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

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

162 participants

Primary outcome timeframe

Up to Month 3

Results posted on

2024-05-23

Participant Flow

Participants in the Patient Providers arm were not assigned to an intervention/control condition. Rather, these providers treated patient participants assigned to both the intervention group and the control group. As such, Participant Flow data on the Patient Provider participants is presented in 1 arm.

Participant milestones

Participant milestones
Measure
Intervention Group: Patients
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group: Patients
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Patient Providers
Patient provider participants included patients' physicians/nurse practitioners. Patient provider participants had appointments with both control and intervention patients.
Overall Study
STARTED
66
68
12
Overall Study
COMPLETED
54
60
11
Overall Study
NOT COMPLETED
12
8
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Intervention Group: Patients
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group: Patients
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Patient Providers
Patient provider participants included patients' physicians/nurse practitioners. Patient provider participants had appointments with both control and intervention patients.
Overall Study
Lost to Follow-up
2
4
0
Overall Study
Time Constraints
4
1
0
Overall Study
Ineligible after enrollment
3
3
0
Overall Study
Clinic / insurance issue
2
0
0
Overall Study
Language barrier
1
0
0
Overall Study
Provider left the clinic
0
0
1

Baseline Characteristics

Sex information is missing from 1 participant in the patient provider arm.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intervention Group: Patients
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group: Patients
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Patient Providers
n=12 Participants
Patient provider participants included patients' physicians/nurse practitioners.
Total
n=126 Participants
Total of all reporting groups
Age, Continuous
53.2 years
STANDARD_DEVIATION 8.72 • n=54 Participants
54.7 years
STANDARD_DEVIATION 7.63 • n=60 Participants
41.7 years
STANDARD_DEVIATION 10.1 • n=12 Participants
49.87 years
STANDARD_DEVIATION 8.82 • n=126 Participants
Sex: Female, Male
Female
0 Participants
n=54 Participants • Sex information is missing from 1 participant in the patient provider arm.
0 Participants
n=60 Participants • Sex information is missing from 1 participant in the patient provider arm.
8 Participants
n=11 Participants • Sex information is missing from 1 participant in the patient provider arm.
8 Participants
n=125 Participants • Sex information is missing from 1 participant in the patient provider arm.
Sex: Female, Male
Male
54 Participants
n=54 Participants • Sex information is missing from 1 participant in the patient provider arm.
60 Participants
n=60 Participants • Sex information is missing from 1 participant in the patient provider arm.
3 Participants
n=11 Participants • Sex information is missing from 1 participant in the patient provider arm.
117 Participants
n=125 Participants • Sex information is missing from 1 participant in the patient provider arm.
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=54 Participants
1 Participants
n=60 Participants
2 Participants
n=12 Participants
3 Participants
n=126 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants
n=54 Participants
0 Participants
n=60 Participants
10 Participants
n=12 Participants
10 Participants
n=126 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
54 Participants
n=54 Participants
59 Participants
n=60 Participants
0 Participants
n=12 Participants
113 Participants
n=126 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=12 Participants
0 Participants
n=126 Participants
Race (NIH/OMB)
Asian
0 Participants
n=54 Participants
0 Participants
n=60 Participants
3 Participants
n=12 Participants
3 Participants
n=126 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=12 Participants
0 Participants
n=126 Participants
Race (NIH/OMB)
Black or African American
54 Participants
n=54 Participants
60 Participants
n=60 Participants
4 Participants
n=12 Participants
118 Participants
n=126 Participants
Race (NIH/OMB)
White
0 Participants
n=54 Participants
0 Participants
n=60 Participants
3 Participants
n=12 Participants
3 Participants
n=126 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=54 Participants
0 Participants
n=60 Participants
0 Participants
n=12 Participants
0 Participants
n=126 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=54 Participants
0 Participants
n=60 Participants
2 Participants
n=12 Participants
2 Participants
n=126 Participants
Region of Enrollment
United States
54 participants
n=54 Participants
60 participants
n=60 Participants
12 participants
n=12 Participants
126 participants
n=126 Participants

PRIMARY outcome

Timeframe: Up to Month 3

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

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Prostate Specific Antigen (PSA) Screening Rates
77.8 Percentage of participants
76.7 Percentage of participants

PRIMARY outcome

Timeframe: Day 1

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.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Patient Knowledge Survey Score
8.13 score on a scale
Standard Deviation 1.33
5.23 score on a scale
Standard Deviation 2.24

PRIMARY outcome

Timeframe: Day 1

Scale consists of 12 items assessing participants' attitudes toward prostate cancer treatment and screening (6 Pros and 6 Cons of testing) scored on a 5 point Likert scale (Strongly Disagree to Strongly Agree). The total score is the sum of responses and ranges from -24 to +24; Positive scores indicate a more favorable assessment of the pros versus the cons of the test.This survey will be administered twice: once directly following the coaching session prior to the patient's appointment, and again following the appointment.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Decision Quality Score
11.2 score on a scale
Standard Deviation 5.42
10.8 score on a scale
Standard Deviation 3.99

PRIMARY outcome

Timeframe: Day 1

Percentage of participants who made an Informed Choice to either undergo or decline PSA testing. Informed choices are those in which: 1\. Men with good knowledge and positive measure of informed choice attitudes (\> or = 22) choose to undergo the test OR 2) Men with good knowledge but negative measure of informed choice attitudes (\<22) towards the test, do not undergo the test The Measure of Informed Choice Attitudes survey is administered twice: once directly following the coaching session prior to the patient's appointment, and again following the appointment and the patient's screening decision is recorded during post-appointment.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Percentage of Participants Who Make Informed Choice
64.8 Percentage of participants
43.3 Percentage of participants

SECONDARY outcome

Timeframe: Day 1

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 raw score is the sum of responses and is transformed to a standard total score ranging from 0 to 100; higher scores indicate "extremely high self-efficacy."

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Decision Self-Efficacy Scale Score
96 score on a scale
Standard Deviation 8.41
94.7 score on a scale
Standard Deviation 9.15

SECONDARY outcome

Timeframe: Day 1

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 average score of responses and ranges from 0 to 5; higher scores indicate greater doctor-patient communication.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Doctor-Patient Communication Survey Score
4.28 score on a scale
Standard Deviation 0.395
4.31 score on a scale
Standard Deviation 0.412

SECONDARY outcome

Timeframe: Day 1

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.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Perceived Efficacy in Patient-Physician Interactions Questionnaire (PEPPI) Score
47.5 score on a scale
Standard Deviation 4.86
47.3 score on a scale
Standard Deviation 4.4

SECONDARY outcome

Timeframe: Day 1

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. Scores lower than 25 are associated with implementing decisions; scores exceeding 37.5 are associated with decision delay or feeling unsure about implementation.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Change in Decisional Conflict Scale Score
17 score on a scale
Standard Deviation 11
21.9 score on a scale
Standard Deviation 13.2

SECONDARY outcome

Timeframe: Day 1

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. The total score is the average of all items and ranges from 1-5. Higher scores indicate greater satisfaction with decision.

Outcome measures

Outcome measures
Measure
Intervention Group
n=54 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=60 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Satisfaction With Decision Scale Score
4.48 score on a scale
Standard Deviation 0.48
4.31 score on a scale
Standard Deviation 0.539

SECONDARY outcome

Timeframe: Month 6

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. Higher scores indicate greater regret. To help others interpret the score more readily with other scales ranging from 0 to 100, these scores can then be converted to a 0-100 scale by subtracting 1 from each item then multiply by 25. To obtain a final score, the items are summed and averaged. The final score presented ranges from 0 to 100, higher scores indicate greater regret.

Outcome measures

Outcome measures
Measure
Intervention Group
n=51 Participants
A decision aid along with decision coaching on PSA screening from a Community Health Worker (CHW). The intervention will be administered directly prior to the participant's appointment with their provider. Education Counseling Session for PSA Screening: counseling from extensively trained CHW
Control Group
n=49 Participants
A decision aid along with CHW interaction on dietary and lifestyle modification to serve as an attention control. The intervention will be administered directly prior to the participant's appointment with their provider. General Health Counseling Coaching: coaching using an educational tool focused on dietary and lifestyle modification
Decisional Regret Scale Survey
21.2 score on a scale
Standard Deviation 15.3
27 score on a scale
Standard Deviation 18.2

Adverse Events

Intervention Group

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Group

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Danil Makarov

NYU Langone Health

Phone: 212-263-4961

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place