The following procedure is needed for the project entitled:
“What’s Going On? An Analysis of the Impact of Patient-Physician Shared Decision Making and Prostate Cancer Screening Among African American Men”
Tests and/or Procedures to be Performed

You have the option to complete this anonymous questionnaire that takes no more than 10 minutes to complete. You are welcome to stop at any time, or to skip any questions that you do not wish to answer.

A Howard University researcher is conducting a survey to determine what doctors are telling African American men about prostate cancer screening. The purpose of the study is to find out what needs to be improved or continued in current doctors’ offices when discussing prostate cancer screening with African American men. Your help would be greatly appreciated. Please answer the questions as honestly as you can. This is an anonymous survey, which means that we ask that you do not write any of your personal information on the paper (e.g., name or phone number). Your participation in this survey is voluntary, and you have the right to stop at any point. You may also skip any questions that you do not wish to answer. There is minimal risk to participating in this study, but it is possible that some questions will make you feel uncomfortable. If this occurs, please feel free to ask questions or state your concerns to the investigators. Thanks in advance for your participation!

To ensure that the anonymity of participants will be protected, the web based questionnaires will not request any personal identifying information in the questionnaire. Therefore, once the participant submits the questionnaire through the online system, no personal identifying information will be included, and the investigators will not be able to identify who completed the questionnaire. Once the study is complete, the electronic questionnaires will be destroyed within 3 years. This system is also password protected, and only the principal investigator and the student investigator will have access to the online questionnaires. If you complete a paper-based questionnaire, you will place the completed questionnaire in a box that will be provided for you to ensure that the researchers do not see who completes the questionnaire. After the data is entered and analyzed from the questionnaires, the questionnaires will be destroyed after 3 years.

You are free to withdraw this consent and discontinue participation in this project at any time without affecting either your right to receive on-going care or your relationship with Howard University, Howard University Hospital, etc.

The Howard University Institutional Review Board will have access to the records of this project.

Dr. Carolyn A. Stroman (principal investigator) can be reached at the following number 202-806-4057 in the event you have any questions regarding your participation in this project. If you have questions any time that you would like to discuss with someone other than the investigators on this project, you are free to contact the Howard University Institutional Review Board at 202-865-8597 between 8:30 a.m. and 5:00 p.m, Mondays and Fridays. You may also contact Dr. Carolyn A. Stroman (principal investigator) at any time for answers to pertinent questions about this research and your research-related rights. You should contact him/her in the event of a research-related injury.

I have read the above description of the research project and I agree to participate in the above-referenced project.

By selecting "next" and beginning the questionnaire, you acknowledge that you have read this information and agree to participate in this research, with the knowledge that you are free to withdraw your participation at any time without penalty for this research project.