Evaluation of a Computer-Based Decision Aid for Promoting Informed Prostate Cancer Screening Decisions Among African American Men: iDecide
Abstract
Purpose: To evaluate the effects of iDecide on prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making among African American men. Design: One-group, pretest/posttest. Setting: Community settings in South Carolina. Participants: African American men, ages 40 years +, without a prior prostate cancer diagnosis (n = 354). Intervention: iDecide, an embodied conversational agent-led, computer-based prostate cancer screening decision aid. Measures: Prostate cancer knowledge, informed decision-making self-efficacy, technology use self-efficacy, and intention to engage in informed decision-making. Analysis: Descriptive statistics, paired t tests, general linear modeling, Spearman correlations. Results: On average, participants experienced significant improvements in their prostate cancer knowledge ( P ≤ .001), informed decision-making self-efficacy ( P ≤ .001), and technology use self-efficacy ( P ≤ .001), postintervention. Additionally, 67% of participants reported an intention to engage in informed decision-making. Conclusion: Given the significant improvements across all measures, this research demonstrates that embodied conversational agent-led decision aids can be used to enhance the capacity for making informed prostate cancer screening decisions among African American men and increase their technology use self-efficacy. One critical limitation of this study is that most men had received prostate cancer screening prior to engaging in our intervention, so the implications of this intervention may be different for men who do not have a history of screening. Additionally, actual engagement in informed decision-making postintervention was not assessed.
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Thematic analysis was used to identify patterns based on previous HCI research.
“Thematic analysis was used to identify patterns based on previous HCI research analyzing similar data [47, 65, 76].”
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Current conversational agents are available via multiple digital platforms (telephones, mobile phones, tablets, computers) and in many virtual formats (chatbots, embodied conversational agents, three-dimensional avatars).
“Current agents are available via multiple digital platforms, including telephones, mobile phones, tablets, and computers, and in many virtual formats such as chatbots, embodied conversational agents, and three-dimensional avatars [2,7,8].”
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Within health care, conversational agents have been designed to automate specialized tasks to support health care professionals, patients, or at-risk populations.
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Conversational agents are helping to provide patient-centered care by increasing patients' involvement in their health care and decision making.
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“Likewise, iDecide, a VA delivering similar information about prostate cancer, significantly increased prostate cancer knowledge and self-efficacy in making informed decisions and using technology [17].”
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- Authors
- Owens, O. L., Felder, T., Tavakoli, A. S., Revels, A. A., Friedman, D. B., Hughes-Halbert, C., & Hébert, J. R.
- Affiliations
- University of South Carolina (US)
- Department of Psychiatry and Behavioral Sciences, Hollings Cancer Center Medical University of South Carolina, Columbia, SC, USA
- Corresponding author
- Owens, Otis L.
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2018-07-11
- Volume
- 33
- Issue
- 2
- Pages
- 267-278
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- OpenAlex
- W2833507391
- Cited by
- 65
- References
- 67
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 10 · 2023: 13 · 2022: 11 · 2021: 4 · 2020: 9 · 2019: 4
- FWCI
- 6.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- Scholar Commons (University of South Carolina) (submittedVersion)
- Funders
- University of South Carolina (Office of the Vice President for Research)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- prostate cancer screening, informed decision-making, decision aids, computer-based decision aid, embodied conversational agents, African American men, decision-making self-efficacy, prostate cancer knowledge, health technology adoption
- MeSH terms
- Adult, Age Factors, Aged, Attitude to Computers, Black or African American, Decision Support Techniques, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Participation, Prostatic Neoplasms, Socioeconomic Factors, South Carolina, Prostate-Specific Antigen, Self Efficacy, Early Detection of Cancer
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