Training Community African American and Hispanic/Latino/a Advocates on Prostate Cancer (PCa): a Multicultural and Bicoastal Approach

Abstract

African American communities are disproportionately impacted by prostate cancer (PCa) compared to other racial/ethnic groups. Whereas the incidence of PCa in Hispanic/Latino men is lower than the incidence in non-Hispanic/Latino White men, Hispanic/Latino men are more likely to be diagnosed with PCa in late stages, and less likely to be knowledgeable about PCa, resulting in significant disparities. We developed, culturally adapted, translated, implemented, and evaluated a PCa Cancer Advocacy Training in African American and Hispanic/Latino/a communities. Culturally and language specific content for African American and Hispanic/Latino/a patients on PCa causes, risk factors, epidemiology, detection, diagnosis, and treatment were delivered through a workshop and simultaneously broadcasted in Spanish in Los Angeles County (n = 29) and in English in Tallahassee, FL (n = 9). Pre- and posttest surveys assessed impact. Pre vs post differences were statistically significant in knowledge (5.0 ± 1.6 vs 6.3 ± 1.1) and advocacy intentions (3.9 ± 0.9 vs 4.3 ± 0.8), on correctly identifying warning signs for PCa (50% vs 87%), intent to inform and educate about PCa within the next 3 months (69% vs 95%), to ensure that high-quality research is sensitive to the priorities of patients (63% vs 84%), to help increase patient recruitment, compliance, and retention for clinical trials within the next month (62% vs 84%), intent to engage in PCa patient education within the next 3 months (67% vs 92%), and in engaging in PCa community outreach within the next 3 months (67% vs 94%). There were no significant differences due to race/ethnicity. The Cancer Advocacy Training led to increased knowledge, awareness, and intention to engage in advocacy regarding PCa in the next 3 months. Results suggest that delivering culturally and language specific educational information increases engagement of Hispanic/Latino/a and African American patient/community advocates.

Understanding Cancer Disparities among African Americans in Los Angeles

“…Regarding interventions for health literacy in this population, one study demonstrated that implementing culturally sensitive CHAs for prostate cancer resulted in signi cant increases in knowledge level. 15 This further validates the need for culturally sensitive interventions in this community to relieve cancer disparities. Additionally, discussions with physicians were associated with greater cancer knowledge and optimism about survival rates, further indicating the importance of culturally sensitive healthcare interactions.…”

“…15 These CHAs possess a deep understanding of the cultural nuances prevalent within their communities, enabling them to offer tailored advice and support, and were shown to in uence increased medical knowledge in the community. 15 Medical mistrust also results in available free services being utilized less frequently. Many African American women rejected free cancer services, stating that they viewed it as associated with a perception of poverty and receiving charity.…”

“…Data included highlights the insu ciency of current physician language and behavior in serving the African American community in Los Angeles. 15 Furthermore, disparities in healthcare facilities themselves have been implicated in racial disparities, with ndings suggesting no signi cant differences in treatment outcomes between African Americans and Caucasians in equal-access healthcare settings, such as VA hospitals in LA, highlighting the impact of unequal access to quality care. 22 This underscores the importance of healthcare facilities adopting policies and practices that promote equity and eliminate disparities in access to care, since this study demonstrated the differences these practices make in racial disparities.…”

“…28 As corroborating evidence, community-based interventions, such as training residents as health advisors, have emerged as effective strategies to bridge cultural gaps and enhance trust within African American populations in LA. 15 These CHAs possess a deep understanding of the cultural nuances prevalent within their communities, enabling them to offer tailored advice and support, and were shown to in uence increased medical knowledge in the community. 15 Medical mistrust also results in available free services being utilized less frequently.…”