Views of African American and Hispanic men about informed decision making for prostate cancer screening: A concept mapping application

Racial/ethnic disparities in prostate cancer can be seen in mortality (African American) and relative survival (Hispanics). Screening for prostate cancer is controversial. Varied professional guidelines suggest men should learn about risks and benefits of screening to make informed decisions consistent with their preferences. We used concept mapping to investigate views of informed decision making of minority men.

16 Hispanic (Mexican American) from Texas and 15 African American men from South Carolina sorted 69 statements about informed decision making into conceptually similar categories and rated their importance. Multidimensional scaling and cluster analysis were used to develop a concept map for informed decision making. Because they were similar, maps of the two ethnic groups were combined.

Half of participants had incomes less than $25,000 and 41% had less than high school education. The central band of the 10 cluster solution related to Sharing and Social Support, Decision to Make, and What to Know. The most important clusters were Future Considerations, What to Know, and Decision to Make. Least important clusters were Drawbacks of Screening, Sharing Information, and Social Support. Recognition of the decision is a central domain and linked to importance of prostate cancer, belief men should participate in the decision, weighing risk and considering peace of mind.

African American and Hispanic men view informed decision making as involving knowledge, a decision process, and engagement with physicians, family, and the larger community. Important concept domains will be incorporated into interventions to support decision making in non-clinical settings.