Impact of pretest on posttest knowledge scores with a Solomon Four research design

There is a paucity of research on the effects of pretest measurement with prostate cancer screening. What effect does a pretest measurement have on posttest outcomes? This research reports knowledge of prostate cancer screening among men randomized to an Enhanced decision aid versus an Usual Care decision aid. Using a Solomon Four research design, there were a total of 198 men in 4 groups. Most of the sample was African American (78%), with a mean age of 52 years. The greatest posttest knowledge occurred with the Enhanced decision aid in contrast to the Usual Care. The Enhanced/Usual Care groups that had both a pretest and posttest and had received a previous digital rectal examination had the highest means (P = .015), with means of 9.1 and 7.0, respectively. Among men who had a previous digital rectal examination, the greatest increase in score occurred among men randomized to the Enhanced decision aid in contrast to the Usual Care decision aid, 2.9 versus 0.4 (P = .008). The outcome varied based on the status of (1) random group assignment of the Solomon Four design and (2) status of previous digital rectal examination. Implications for nurses include consideration 1 of a pretest to increase posttest knowledge scores.