Effectiveness of a Community Health Worker-Led Intervention on Knowledge, Perception, and Prostate Cancer Screening among Men in Rural Kenya

Abstract

Background. Globally, an increase in mortality from prostate cancer (PC) remains a big challenge with disparities existing with a slight preponderance among men in low and middle-income countries. Prostate cancer is a leading cause of mortality among men in sub-Saharan Africa. In Kenya, despite the majority of men presenting with advanced prostate cancer for treatment, knowledge and screening for prostate cancer is low. The study aimed to examine the effectiveness of a community health worker-led education intervention on knowledge, perception, and PC screening. Methods. This was a quasiexperimental study among Kenyan men aged 40–69 years. The intervention site was Gatundu North subcounty and the control site was Kiambu subcounty in Kiambu County. Stratified random sampling was applied to select 288 respondents per arm of the study. We used a pretested interviewer-administered questionnaire to collect data at baseline and 6 months postintervention. Pearson’s chi-square test was used for data analysis. Results. Awareness of prostate cancer significantly increased postintervention P < 0.05 . The proportion of respondents who had good knowledge of prostate cancer increased significantly from 49% to 76.4% P < 0.05 in the intervention arm. The proportion of respondents with a high perception of self-vulnerability increased significantly from 26% to 42.1% P < 0.05 . The proportion of men who had undergone PC screening significantly increased from 4.5% to 20.4% P < 0.05 in the intervention arm. In postintervention, there was a statistically significant difference in the proportion of men screened for prostate cancer in the intervention and control arm P < 0.05 . Conclusion. Health education by community health workers during household visits increased awareness and knowledge, perception, and uptake of PC screening. Utilization of community health worker delivered education is an effective strategy that requires to be adopted to enhance screening.

Potential New Approaches for Prostate Cancer Management in Resource-Limited Countries in Africa

“…Such trials can use the alleviation of symptoms and the reduction of PSA as endpoints in relatively small and short randomized studies; these are needed to make progress in providing medical care for men with prostate cancer in SSA and other LLMICs around the world. Additionally needed is: the training of more urologist and urologic oncologists, focusing on their ability to perform biopsies and prostate surgery; the improvement of clinical facilities, including those for radiotherapy and laboratory and pathology diagnosis; the development of prostate cancer awareness and education among the general public, as well as the medical community in SSA [42].…”

Knowledge, attitude and practice on screening and early diagnosis of prostate cancer of primary health care providers in the Free State

“…Studies exploring this subject are, however, scarce in our study setting. Foreign studies 28,29 have shown the roles of nurses and community healthcare workers in health promotion and SDM relating to PCa screening. These roles should be encouraged among these nonmedical PHC cadres, who are first-line PHC providers in South African local communities and clinics.…”