4.3 Article

Promoting informed prostate cancer screening decision-making for African American men in a community-based setting

Journal

CANCER CAUSES & CONTROL
Volume 33, Issue 4, Pages 503-514

Publisher

SPRINGER
DOI: 10.1007/s10552-021-01544-9

Keywords

Prostate cancer; Health disparities; Cancer screening; Decision-making; Community-based participatory research

Funding

  1. Emerson, Ascension Health, and Express Scripts

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This study evaluated the impact of an educational outreach program on the decision-making abilities of African American men regarding prostate cancer screening. The program successfully improved participants' knowledge, beliefs, attitudes, anxiety levels, and self-efficacy, ultimately leading to informed decision-making.
Purpose Current screening guidelines for prostate cancer (PCa) encourage men to make individual screening decisions after consulting with their primary care provider to weigh the risks and benefits of undergoing prostate specific antigen (PSA) testing, but many men at high risk of PCa diagnosis (notably African American men) are more likely to be uninsured and lack a primary care provider. An academic-community partnership redesigned its community-based screening program to ensure access to services for African American men, incorporating a session with a trained clinical educator in community settings, designed to increase knowledge and promote informed decision-making regarding PSA testing. This study evaluated effects of the intervention on decision-making outcomes. Methods To evaluate program efficacy, 88 men completed pre- and post-test surveys assessing outcomes of interest. Results Participants' knowledge, beliefs, attitudes, anxiety levels, and self-efficacy all improved from pre- to post-test at a statistically significant level. Most notably participants' awareness that PCa is often not life-threatening, and watchful waiting is a reasonable treatment option increased after the encounter. More than half of the study sample felt they had received enough knowledge to make an informed decision about whether the PSA test was right for them. Conclusion Our findings show the program had positive effects on men's ability to make informed decisions about PCa screening and demonstrate that educational outreach programs with an emphasis on informed decision-making can effectively balance screening guidelines with the needs of underserved populations in community settings to improve outcomes.

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