Veteran Peer Navigators to Promote Shared Decision Making for PSA Screening

The project will investigate the efficacy of a Veteran-peer-navigator-led decision coaching (PDC) program to promote Shared Decision Making (SDM) for prostate cancer screening among Veterans at the Veterans Health Administration (VA). Prostate cancer is commonly screen detected using PSA, a non-specific test which has led to modest population-level survival benefits at the cost of over-detection of low-risk disease. This trade off in outcomes is ideally addressed using SDM which can be challenging to implement in time constrained primary care office visits. The investigators propose the evaluation of a PDC intervention to promote SDM for PSA screening to improve both access and quality of care for Veterans. The investigators results will enhance understanding of the efficacy, cost-effectiveness, and sustainability of PDC interventions for SDM promotion across communication formats in the VA. Lessons learned through this proposal will not only improve quality of care for PSA screening but also will suggest a paradigm for dissemination of SDM across preventive services.

Inclusion Criteria: Veteran patient participants: * Veteran * Male * Attending VANYHHS-Manhattan for routine primary care appointment Providers: * Primary care provider at VA New York Harbor Healthcare System (VANYHHS) * Caring for patients that fit inclusion criteria Exclusion Criteria: Veteran Patients: * Patients seen within 9 months of other PSA tests * Patients seen within 180 days after primary diagnosis of urinary obstruction, prostatitis, hematuria, other disorder of prostate, unexplained weight loss, or lumbar back pain * Patients with a prior diagnosis of prostate cancer (ICD-10-CM C61) * Patients visiting their provider for any indication other than a well-visit appointment Providers: \- Providers who do not treat adult male patients (e.g. OB/Gyns, pediatricians)