Laura D Scherer1, Jeffrey T Kullgren2,3,4,5, Tanner Caverly2,3,4,5, Aaron M Scherer6, Victoria A Shaffer1, Angela Fagerlin7,8, Brian J Zikmund-Fisher3,4,5,9. 1. Department of Psychological Sciences, University of Missouri, Columbia MO, USA. 2. VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. 3. Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA. 4. Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI, USA. 5. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA. 6. Division of General Internal Medicine, University of Iowa, Iowa City, IA, USA. 7. VA Salt Lake City Center for Informatics Decision Enhancement and Surveillance (IDEAS), Salt Lake City, UT, USA. 8. Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA. 9. Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA.
Abstract
PURPOSE: The recently developed Medical Maximizer-Minimizer Scale (MMS) assesses individual differences in preferences for active v. passive medical treatment. We hypothesized that men's maximizing-minimizing preferences might have relevance in the case of prostate-specific antigen (PSA) screening, since there is considerable variability in men's preference for being screened even among men who are informed that harm is more likely than benefit. The current research examined whether MMS preferences predict how men respond to didactic information and narrative stories about PSA screening. DESIGN:US men 40+ years old ( N = 1208) participated in an online survey. Men viewed information about PSA screening in 3 phases and provided their preference for screening after each phase. Phase 1 described what PSA screening is. Phase 2 added didactic information about screening risks and benefits. Phase 3 added narrative stories; men were randomized to receive stories about 1) physical harm, 2) emotional harm, 3) overdiagnosis, or 4) all 3 stories. Participants also completed the validated MMS. RESULTS: After receiving basic information, 76.8% of men wanted PSA screening. After receiving information about risks and benefits, 54.8% wanted screening (a significant reduction, P < 0.001). Men who changed their preferences were significantly more likely to be minimizers than maximizers; most men with maximizing tendencies wanted screening after both the didactic information and narratives, whereas most men with minimizing tendencies did not want the test after receiving information. CONCLUSIONS: Men who prefer a more minimizing approach to medicine are more responsive to evidence supporting limiting or forgoing screening than men who prefer a maximizing approach.
RCT Entities:
PURPOSE: The recently developed Medical Maximizer-Minimizer Scale (MMS) assesses individual differences in preferences for active v. passive medical treatment. We hypothesized that men's maximizing-minimizing preferences might have relevance in the case of prostate-specific antigen (PSA) screening, since there is considerable variability in men's preference for being screened even among men who are informed that harm is more likely than benefit. The current research examined whether MMS preferences predict how men respond to didactic information and narrative stories about PSA screening. DESIGN: US men 40+ years old ( N = 1208) participated in an online survey. Men viewed information about PSA screening in 3 phases and provided their preference for screening after each phase. Phase 1 described what PSA screening is. Phase 2 added didactic information about screening risks and benefits. Phase 3 added narrative stories; men were randomized to receive stories about 1) physical harm, 2) emotional harm, 3) overdiagnosis, or 4) all 3 stories. Participants also completed the validated MMS. RESULTS: After receiving basic information, 76.8% of men wanted PSA screening. After receiving information about risks and benefits, 54.8% wanted screening (a significant reduction, P < 0.001). Men who changed their preferences were significantly more likely to be minimizers than maximizers; most men with maximizing tendencies wanted screening after both the didactic information and narratives, whereas most men with minimizing tendencies did not want the test after receiving information. CONCLUSIONS:Men who prefer a more minimizing approach to medicine are more responsive to evidence supporting limiting or forgoing screening than men who prefer a maximizing approach.
Entities:
Keywords:
PSA screening; cancer screening; medical decision making; prostate cancer; screening communication
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