Evaluation of a spiritually-based educational program to increase informed decision making for prostate cancer screening in African American churches

African American men are more likely to develop prostate cancer and twice as likely to die from the disease than are White men. Informed decision making (IDM) is encouraged, in which men make the best choice based on their risk, values, and preferences. IDM programs have been delivered through community settings, such as churches. One way of making cancer communication interventions more culturally relevant, and to potentially improve the effectiveness of church-based programs, is to integrate spiritually-based content. This is done by including relevant spiritual themes to frame the cancer educational message thereby putting health in a spiritual context. In the present study, the community was actively involved in the development of a spiritually-based intervention promoting IDM for prostate cancer screening in urban African American churches. The effectiveness of the spiritually-based intervention was compared in a pilot study using a randomized controlled design where two churches were randomized to receive either the spiritually-based intervention or an intervention of the same core prostate cancer content but presented in a non-spiritual (e.g., secular, traditional medical model) manner. Men from each church were trained (separately) as Community Health Advisors, to lead an educational session on prostate cancer and IDM for screening. The session was guided by print materials developed and pilot tested for this study. Study outcomes included prostate cancer knowledge, perceived barriers to and benefits of screening, informed decision making, and satisfaction with the program, assessed at baseline and immediate follow-up through use of a self-administered survey.