PD64-10 IMPACT OF HEALTH LITERACY ON DECISION-MAKING FOR PROSTATE-SPECIFIC ANTIGEN SCREENING IN THE UNITED STATES

You have accessJournal of UrologyProstate Cancer: Detection & Screening VIII (PD64)1 Apr 2019PD64-10 IMPACT OF HEALTH LITERACY ON DECISION-MAKING FOR PROSTATE-SPECIFIC ANTIGEN SCREENING IN THE UNITED STATES David-Dan Nguyen*, Quoc-Dien Trinh, Paul L. Nguyen, and Jesse D. Sammon David-Dan Nguyen*David-Dan Nguyen* More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , Paul L. NguyenPaul L. Nguyen More articles by this author , and Jesse D. SammonJesse D. Sammon More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557449.69011.e8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Multiple factors, such as widespread reporting of guidelines, influence a patient’s decision to undergo prostate-specific antigen (PSA) testing. Following the USPSTF recommendations,patients with improved health literacy (HL) would presumably have a lower probability of screening (given increased awareness of guidelines). We sought to identify the impact of HL on informed decision-making (IDM) and PSA screening decisions. METHODS: Using the 2016 Behavioral Risk Factor Surveillance System (BRFSS) dataset, we examined data from 13 states that administered the optional “Health Literacy” module. Men aged 50 and older were examined. Complex samples multivariable logistic regression models were computed to the odds of receiving PSA screening. Age, race, education level, marital status, health insurance,health status, residence location, annual income, recommendation by a healthcare provider (HCP) and health literacy category were included as covariates. The interactions between health literacy and HCP Recommendation were examined. RESULTS: We identified 12.249M men with a rate of PSA screening of 33.4%. Among this cohort, only 34.5% self-identified as having optimal health literacy. Rates of PSA screening were highest amongst the most health literate (42.2% vs 23.3%). While the receipt of Healthcare Provider Recommendation to undergo PSA screening was the most important independent predictor (OR=10.357, CI [9.103, 11.784]) of screening. This effect was significantly diminished in the population of men with the highest health literacy (p-int <0.05). CONCLUSIONS: In the uncertain environment of multiple contradictory screening guidelines, men who report higher levels of health literacy had higher levels of screening. While recommendation from a healthcare provider to undergo PSA screening remains the most important predictor, the effect is significantly moderated by HL. These findings highlight the dynamic interplay between providers and their patients that should inform the creation and promulgation of guidelines. Source of Funding: Brigham Research Institute, Bruce A. Beal and Robert L. Beal Surgical Fellowship, Conquer Cancer Foundation, Defense Health Agency, Intuitive Surgical, Prostate Cancer Foundation, Vattikuti Urology Institute. Boston, MA; Portland, ME© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1184-e1185 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information David-Dan Nguyen* More articles by this author Quoc-Dien Trinh More articles by this author Paul L. Nguyen More articles by this author Jesse D. Sammon More articles by this author Expand All Advertisement PDF downloadLoading ...