Affecting African American Men’s Prostate Cancer Screening Decision-making through a Mobile Tablet-Mediated Intervention

African American men experience a 60% higher incidence of prostate cancer and are more than twice as likely to die from it than White men. Evidence is insufficient to conclude that definitively screening for prostate cancer reduces the likelihood of morbidity or death. Patients are encouraged to discuss screening alternatives with health care providers for informed decision-making (IDM). The extent of IDM in clinical or community setting is not known. This study uses data from a community-based, computer-mediated, IDM intervention that targeted 152 African American aged 40 to 70. Pretest-posttest differences in means for prostate cancer knowledge, screening decisional conflict, and screening decisional self-efficacy were examined by two-tailed t-tests. Overall, the intervention significantly improved respondents’ prostate cancer knowledge (p<.0001), significantly improved decisional self-efficacy (p<.0001) and significantly reduced decisional conflict (p<.0001). Specifically, the intervention significantly promoted IDM among men who reported more education, being married, having financial resources, and younger age.

[1]  W. Isaacs,et al.  Explaining racial differences in prostate cancer in the United States: Sociology or biology? , 2005, The Prostate.

[2]  A. O'Connor,et al.  Validation of client decision-making instruments in the context of psychiatry. , 1996, The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres.

[3]  K. Glanz,et al.  Health behavior and health education : theory, research, and practice , 1991 .

[4]  Leda M. Pérez,et al.  Community health workers: social justice and policy advocates for community health and well-being. , 2008, American journal of public health.

[5]  David Chia,et al.  Mortality results from a randomized prostate-cancer screening trial. , 2009, The New England journal of medicine.

[6]  Angela Glover Blackwell,et al.  Community-based participatory research: implications for public health funding. , 2003, American journal of public health.

[7]  D. Berwick Disseminating innovations in health care. , 2003, JAMA.

[8]  Monique J. Roobol,et al.  Mortality Results from a Randomized ProstateCancer Screening Trial , 2009 .

[9]  T. Wynn,et al.  African American Community Health Advisors Trained as Research Partners: Recruitment and Training , 2005, Family & community health.

[10]  K. Lohr,et al.  Outcomes and Costs of Community Health Worker Interventions: A Systematic Review , 2010, Medical care.

[11]  G. Chodak,et al.  Educating African-American men about prostate cancer: impact on awareness and knowledge. , 2003, Urology.

[12]  C. Manfredi,et al.  Factors Influencing Medical Information Seeking Among African American Cancer Patients , 2002, Journal of health communication.

[13]  Ann Barry Flood,et al.  Modifying unwarranted variations in health care: shared decision making using patient decision aids. , 2004, Health affairs.

[14]  J. Stanford,et al.  Validation study of retrospective recall of disease-targeted function: results from the prostate cancer outcomes study. , 2000, Medical care.

[15]  P. Mullen,et al.  Translating Cancer Prevention and Control Research into the Community Setting: Workforce Implications , 2012, Journal of Cancer Education.

[16]  Louie E. Ross,et al.  African American men, prostate cancer screening and informed decision making. , 2003, Journal of the National Medical Association.

[17]  Valerie A. Clarke,et al.  Unrealistic Optimism and the Health Belief Model , 2000, Journal of Behavioral Medicine.

[18]  A. O'Connor Validation of a Decisional Conflict Scale , 1995, Medical decision making : an international journal of the Society for Medical Decision Making.

[19]  J E Poss,et al.  Developing a new model for cross-cultural research: synthesizing the Health Belief Model and the Theory of Reasoned Action. , 2001, ANS. Advances in nursing science.

[20]  B. Smedley,et al.  Unequal Treatment: Con-fronting Racial and Ethnic Disparities in Health Care , 2002 .

[21]  Maria E Fernandez,et al.  Measures used in studies of informed decision making about cancer screening: A systematic review , 2006, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[22]  J. LaFountain Inc. , 2013, American Art.

[23]  Screening for prostate cancer: U.S. Preventive Services Task Force recommendation statement. , 2008, Annals of internal medicine.

[24]  B. Rimer,et al.  Informed decision making: What is its role in cancer screening? , 2004, Cancer.

[25]  Rachel C. Shelton,et al.  A Computer-Tailored Intervention to Promote Informed Decision Making for Prostate Cancer Screening Among African American Men , 2009, American journal of men's health.

[26]  D. Bowen,et al.  Factors influencing prostate cancer screening decisions among African American men. , 2007, Ethnicity & disease.

[27]  M. Campbell,et al.  Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men. , 2006, Journal of the National Medical Association.

[28]  Constantine Daskalakis,et al.  Preparing African-American men in community primary care practices to decide whether or not to have prostate cancer screening. , 2005, Journal of the National Medical Association.