Pilot testing an African centered prostate cancer community-based decision-making curriculum

Background: Trend data continues to reflect persistent prostate cancer (PCa) mortality disparities, especially for African Americans. Widespread PCa awareness campaigns in America have not produced behavior change in men of African ancestry toward prevention and early detection. Research on community-based decision making tools targeting men of African ancestry for PCa behavior change remains scarce. Utilizing community-based participatory research (CBPR) methods we obtained the perspective of over 500 men of African ancestry on PCa early detection and prevention. Information obtained was used by a cohort of this group, who represented diverse backgrounds, lifestyles, and socioeconomic status to develop an African centered, community-based PCa prevention and early detection decision-making curriculum, to increase self-efficacy. This paper presents the pilot testing outcomes.

Methods: Four male sample groups were selected by environmental settings, Group 1- church; Group 2-urban Masonic Lodge; Group 3- rural Masonic Lodge; and Group 4- inner city community group. We conducted a 2-hour interactive session once a week for four weeks utilizing multiple delivery methods. Curriculum consists of four modules. To measure knowledge change pre and post test were conducted. Analysis was used to validation content, delivery, style, and administration dose.

Results: N=56, Group1=26, Group2=8, Group3=11, and Group4=11 (Control). Average age 63.7 years (SD=10.5 years). Variation in knowledge change and practice intent differed by groups. At pretest, Group4 (Control) scored 100%. At posttest, Group3 experienced the highest level of knowledge gain at 68%. Across Groups 1, 2 and 3 at baseline, 64.7% could not identify a single risk factor for PCa. At posttest, 63.9% of Groups 1, 2, and 3 could name at least six risk factors and four ways to have good prostate health. Attendance was 98% for Groups 2 and 3, but 31% for Group1. Immediately following the pilot testing, 80% of Group1 participated in a scheduled PSA and DRE screening; all other men expressed intent to be screened.

Conclusions: Results indicated that African American men were willing to change health seeking behaviors, increase participation in prevention and early detection activities, and increase self-efficacy toward prostate cancer prevention, screening and early detection.