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APHA Scientific Session and Event Listing

David Driscoll, PhD, MPH¹, Lauren McCormack, PhD¹, Cindy Soloe, MPH¹, Jon Poehlman, PhD¹, Pamela Williams-Piehota, PhD¹, Kathleen Lohr, PhD¹, Russell Harris, MD, MPH², Stacey Sheridan, MD, MPH², Carol E. Golin, MD, MPH³, and Sam Cykert, MD⁴. (1) Health Promotion Research, RTI International, 3040 Cornwallis Road, Research Triangle Park, NC 27709, 919-541-6565, driscoll@rti.org, (2) School of Medicine, UNC-Chapel Hill, Cecil G. Sheps Center, CB#7590, 725 Airport Road, 2nd floor, Chapel Hill, NC 27599, (3) Cecil G. Sheps Center for Health Services and Research, 725 Airport Road CB7590, Chapel Hill, NC 27599, (4) Internal Medicine Program, Moses Cone Hospital, 1200 N Elm Street, Greensboro, NC 27401

Clinical evidence is insufficient to recommend for or against routine screening for prostate cancer using the prostate-specific antigen (PSA) test, and men should decide whether to have this test in consultation with their doctors. Though many studies have evaluated interventions to promote informed decisionmaking in a clinical setting, few have assessed such interventions at the community-level. In this study we conducted community-based educational interventions to promote informed decisionmaking about the PSA test. We used ethnographic methods to identify three lower and three upper socioeconomic-status (SES) communities, define their boundaries, and select community organizations for our interventions. We administered pre-, post-, and six month follow-up surveys and in-depth interviews with approximately 500 men. During intervention sessions, men of both sets of SES communities were highly engaged in group deliberations of the PSA decision. Immediately following the interventions, members of both lower and upper SES communities felt “it was okay” to make an informed decision not to have the PSA test. Members of the upper SES communities were significantly more likely to agree with the statement after six months, suggesting that message reinforcement may be more important in lower SES communities. Members of the lower SES communities were also significantly more fatalistic about their health than members of the upper SES communities, which may make them less receptive to interventions stressing active participation in health decisions. These community-specific differences in values and attitudes, with others to be described, should be incorporated in future campaigns to promote informed decisionmaking among medically under-served populations.

Learning Objectives:

• Recognize the benefits of community-based interventions for promoting informed clinical decision making.
• Describe how ethnographic methods can be employed for the selection of communities and identification of community organizations.
• Discuss the implications of community-level differences for the promotion of informed decision making.

Keywords: Cancer Screening, Community Education

Presenting author's disclosure statement:

Any relevant financial relationships? No