A Tailored Prostate Cancer Education Intervention for Low-income African Americans: Impact on Knowledge and Screening

Abstract

African American men bear disproportionate burden of prostate cancer (PCa) that can be reduced by early detection. A 15-minute culturally appropriate PCa education intervention developed to communicate effective, relevant, and balanced PCa screening information to low-income African American men was evaluated in men 42 years and older who had not been screened in one year. Of 539 men enrolled, 392 (72.7%) completed the six-month follow-up. Mean age was 54.4±8.9, 34.7% had no high school diploma, and 65.3% earned less than $25,000 annually. Barriers to screening included health insurance (41.4%), discomfort of digital rectal exam (32.1%), and fear of cancer diagnosis (29.9%). Mean knowledge score of 21 points increased from 13.27±3.51 to 14.95±4.14 (p<.001), and prostate-specific antigen screening from 22.1% to 62.8%. Men without high school diploma recorded the lowest post-intervention PCa knowledge and screening rate (47.7%), suggestive of the need for more than a single education session. Annual physicals with free prostate examination can maintain the positive trend observed.

Enhancing Knowledge, Beliefs, and Intention to Screen for Prostate Cancer via Different Health Educational Interventions: a Literature Review

“…A recent study, Ukoli et al (2013) observed the impact of tailored prostate cancer education on knowledge and screening among 539 low-income African Americans men and found that 15-minutes education interventions (providing a prostate cancer brochure and tailored interaction) led to improved knowledge, beliefs, and action. Furthermore, researchers showed that a balanced educational intervention on the risks and benefits of prostate cancer screening helped provide a platform for participants to make informed decisions and dramatically increased PSA testing, among men who did not have access to regular physical examinations.…”

The National Cancer Institute’s Community Networks Program Initiative to Reduce Cancer Health Disparities: Outcomes and Lessons Learned

“…For example, CNP reports described culturally tailored interventions that resulted in reduced tobacco use among Asian immigrants 46 and Native Hawaiians. 47 They described CBPR projects that attracted rural dwelling adults to cancer screening for the first time 40 ; increased breast and cervical cancer screening among Vietnamese, Hmong, Micronesian, Hispanics, and African-American women 17,23,48–50 ; increased colorectal cancer screening among Chinese Americans, 44 Hispanics, 51,52 and African Americans 53 ; increased Pap test follow-up among American Indian women 54 ; increased hepatitis B immunization among Asian Americans 55 ; increased prostate cancer screening among African Americans 56,57 ; and increased minority participation in clinical trials. 58,59 …”

Intrapersonal and community factors associated with prostate cancer screening among African-American males in the US

“…45 Likewise, the lack of health insurance as well as the cost for PCS have been identified as primary barriers to receiving PCS. 46 It is unfortunate that a lack of health facilities and educational awareness regarding PCa may be viewed as barriers to receiving PCS as well as additional health promotion and preventive services. 29 Talcott et al 32 reported AA males as being less likely to access and receive a consistent source of health care.…”