Improving Shared Decision Making in Latino Men With Prostate Cancer: A Thematic Analysis

Joaquin Michel, Jorge Andres Ballon Echegaray, Sarah E. Connor, David C. Johnson, Jonathan Bergman, Christopher S. Saigal, Mark S. Litwin, Dana L. Alden

Research output: Contribution to journalReview articlepeer-review

Abstract

Background. Multiple studies have shown that digitally mediated decision aids help prepare patients for medical decision making with their providers. However, few studies have investigated whether decision-support preferences differ between non-English-speaking and English-speaking Latino men with limited literacy. Objective. To identify and compare health information seeking patterns, preferences for information presentation, and interest in digital decision aids in a sample of Southern Californian underserved Latino men with newly diagnosed prostate cancer at a county hospital. Methods. We conducted semistructured, in-depth telephone interviews with 12 Spanish-speaking and 8 English-speaking Latino men using a purposive sampling technique. Following transcription of taped interviews, Spanish interviews were translated. Using a coding protocol developed by the team, two bilingual members jointly analyzed the transcripts for emerging themes. Coder agreement exceeded 80%. Differences were resolved through discussion. Results. Thematic differences between groups with different preferred languages emerged. Most respondents engaged in online health information seeking using cellphones, perceived a paternalistic patient-provider relationship, and expressed willingness to use hypothetical digital decision aids if recommended by their provider. English speakers reported higher digital technology proficiency for health-related searches. They also more frequently indicated family involvement in digital search related to their condition and preferred self-guided, web-based decision aids. In comparison, Spanish speakers reported lower digital technology proficiency and preferred family-involved, coach-guided, paper and visual decision aids. English speakers reported substantially higher levels of formal education. Conclusion. Preferences regarding the use of digital technology to inform prostate cancer treatment decision making among underserved Latino men varied depending on preferred primary language. Effective preparation of underserved Latino men for shared decision making requires consideration of alternative approaches depending on level of education attainment and preferred primary language.

Original languageEnglish
JournalMDM Policy and Practice
Volume6
Issue number1
DOIs
StatePublished - 2021
Externally publishedYes

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dean?s Leadership in Health and Science Scholarship at David Geffen School of Medicine at UCLA and William R. Johnson Jr. Distinguished Professorship, Shidler College of Business, University of Hawai?i.

Publisher Copyright:
© The Author(s) 2021.

Keywords

  • decision aids
  • Latino men
  • prostate cancer
  • qualitative research
  • shared decision making

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