Entertainment education for prostate cancer screening: a randomized trial among primary care patients with low health literacy

Patient Educ Couns. 2008 Dec;73(3):482-9. doi: 10.1016/j.pec.2008.07.033. Epub 2008 Aug 29.


Objective: To evaluate an entertainment-based patient decision aid for prostate cancer screening among patients with low or high health literacy.

Methods: Male primary care patients from two clinical sites, one characterized as serving patients with low health literacy (n=149) and the second as serving patients with high health literacy (n=301), were randomized to receive an entertainment-based decision aid for prostate cancer screening or an audiobooklet-control aid with the same learner content but without the entertainment features. Postintervention and 2-week follow-up assessments were conducted.

Results: Patients at the low-literacy site were more engaged with the entertainment-based aid than patients at the high-literacy site. Overall, knowledge improved for all patients. Among patients at the low-literacy site, the entertainment-based aid was associated with lower decisional conflict and greater self-advocacy (i.e., mastering and obtaining information about screening) when compared to patients given the audiobooklet. No differences between the aids were observed for patients at the high-literacy site.

Conclusion: Entertainment education may be an effective strategy for promoting informed decision making about prostate cancer screening among patients with lower health literacy.

Practice implications: As barriers to implementing computer-based patient decision support programs decrease, alternative models for delivering these programs should be explored.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Computer-Assisted Instruction / methods*
  • Decision Support Techniques*
  • Educational Status
  • Follow-Up Studies
  • Humans
  • Informed Consent
  • Male
  • Mass Screening* / methods
  • Mass Screening* / psychology
  • Middle Aged
  • Multimedia
  • Pamphlets
  • Patient Education as Topic / methods*
  • Patient Participation* / methods
  • Patient Participation* / psychology
  • Primary Health Care / methods
  • Prostatic Neoplasms* / diagnosis
  • Prostatic Neoplasms* / psychology
  • Self Efficacy
  • Surveys and Questionnaires
  • Tape Recording
  • Television