Abstract B173: The Prostate Health Equity Project: Shared decision-making support for patients and providers in prostate cancer screening

Abstract

Black men experience disproportionate prostate cancer incidence and mortality, yet screening recommendations vary and shared decision-making (SDM) remains difficult to implement consistently in primary care. As part of the multilevel Prostate Health Equity Project, we sought to identify clinician-informed design requirements for a paired patient- and provider-facing SDM toolkit supporting screening conversations with Black men. Using a human-centered design approach, a community-academic team developed an early toolkit prototype with a conversation pathway, clinician prompts, common patient questions, a patient-facing decision form, and a modeled conversation component. The prototype was presented during a 60-minute interactive clinician feedback session at the May 2026 National Medical Association Region IV Conference, which primarily engages Black physicians and other health professionals. Approximately 29 clinicians attended; 13 completed a survey. Survey responses were summarized descriptively, while discussion transcripts and facilitator notes underwent rapid formative analysis. All respondents had been in practice for more than 10 years, and 46% were family medicine or internal medicine/primary care physicians. Although 77% felt somewhat or very confident discussing screening, only 46% reported these conversations occurred often or very often. The most frequently selected challenges were explaining benefits and harms and reconciling guideline differences (31% each), followed by discussing screening with higher-risk patients, including Black men (23%). Plain-language patient education materials were the most commonly selected support need (69%); guidance on reconciling guidelines and examples for explaining benefits, harms, and follow-up were each selected by 46%. Among respondents to the format item, 64% preferred a paired provider- and patient-facing approach; one-page handouts and website resources were each preferred by 62%. Rapid analysis contextualized these findings. Clinicians described SDM as difficult to fit within time-limited visits and emphasized practical language and visual tools rather than lengthy guidance. Some noted that screening decisions may require more than one conversation. Participants also stressed the need to address follow-up after abnormal results, sexual function, family or patient advocates, and patient-centered audio or video formats. Survey and discussion findings converged on the need for a concise, visually accessible, paired patient-clinician resource that addresses guideline variation, communicates benefits and harms, and supports follow-up after screening. These findings are guiding toolkit refinement before feasibility testing. Additional engagement with family medicine clinicians is planned to assess usability and inform the next prototype, complementing PHEP’s community-facing work. M. Muska Nataliansyah, Kevin Izard, Adam Murphy, Torojah Williams, Tobi Cawthra, Jayme Ewens, Laura Pinsoneault, Kathleen O'Connell, Shannon Reed, Ambrose Brown-Wilson, Joan Neuner, Melinda Stolley. The Prostate Health Equity Project: Shared decision-making support for patients and providers in prostate cancer screening [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr B173.