Racial differences in veterans’ response to a standard vs. patient-centered decision aid for prostate cancer: Implications for decision making in African American and White men

•A secondary analysis of a study of men diagnosed with early stage prostate cancer.•Racial differences in response to two different decision aids (DA) were evaluated.•White patients who received the patient-centered DA preferred active surveillance.•African American patients’ treatment preferences did not differ as a function of DA. To determine whether racial differences exist in patient preferences for prostate cancer treatment after being informed about options using a patient-centered vs. a standard decision aid (DA). This article reports secondary analyses of a large study of men diagnosed with early stage prostate cancer. Men were recruited from 4 VA Health Systems and randomized to receive a patient-centered or standard DA about prostate cancer treatment options. Data were collected at 1) baseline, 2) after reading the DA but prior to diagnosis, and 3) after receiving a cancer diagnosis and meeting with a urologist. White patients who received the patient-centered DA written at a 7th grade reading level were more likely to prefer active surveillance and less likely to prefer radiation compared to those who received the standard DA written at >9th grade reading level. African American patients’ treatment preferences did not differ as a function of DA. When informed about prostate cancer treatment options through a patient-centered DA, White patients changed their treatment preferences but African American patients did not. As DAs are increasingly being used in clinical practice, more research is needed regarding the efficacy, relevance, and receptivity of DAs for African Americans.