4.2 Article

Barriers and Facilitators to Informed Decision-Making About Prostate Cancer Screening Among Black Men

Journal

JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE
Volume 34, Issue 5, Pages 925-936

Publisher

AMER BOARD FAMILY MEDICINE
DOI: 10.3122/jabfm.2021.05.210149

Keywords

Cancer Screening; Decision Making; Focus Groups; Health Care Disparities; Primary Health Care; Prostate Cancer

Funding

  1. South Carolina Clinical and Translational Research (SCTR) Institute
  2. Medical University of South Carolina, through NIH [UL1RR029882, UL1 TR000062]

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Black men may lack the prerequisite information to make informed decisions about PrCa screening, which is notable in light of known PrCa racial disparities. Clinicians can facilitate informed decision-making by discussing the benefits and risks of PrCa screening, educating about racial disparities, and engaging in open communication with Black men.
Background: Black men are disproportionately impacted by prostate cancer (PrCa). Current guidelines recommend that all men make informed decisions about whether to be screened for PrCa. Little is known about the barriers and facilitators of informed decision-making (IDM) about PrCa screening in Black men. Metbods: We conducted focus groups with a convenience sample of Black men aged 55 to 69 years from a primary care practice (n = 21). Template analysis was used to evaluate themes related to bar-riers and facilitators of IDM about PrCa screening. Results: IDM was impacted by external factors, intrinsic factors, and personal beliefs about PrCa screen-ing. Family, friends, and clinicians played a paramount role in shaping attitudes about PrCa screening. Distrust of the medical community impaired IDM, and lack of clinician communication about PrCa screening further engendered mistrust. Participants felt they lacked adequate knowledge to make an informed decision about PrCa screening. Identified areas to promote IDM included education on racial disparities, education that screening is a personal choice, and differentiating PrCa screening from colon cancer screening. Conclusions: Our results indicate that Black men may lack the prerequisite information to make informed decisions about PrCa screening, which is notable in light of known PrCa racial disparities. Clinicians can play an important role in facilitating IDM through fostering discussions about the bene-fits and risks of PrCa screening and educating Black men about racial disparities.

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