Informed decision making in a new age: Technology use in informing older southern African-American men about prostate cancer screening

BACKGROUND: The American Cancer Society recommends that men engage in informed decision making (IDM) with their doctor about prostate cancer (PrCa) screening beginning at age 50 [45 for high-risk groups such as African Americans (AA)]. Because older AAs are significantly more likely to die from PrCa than other racial groups, there is a critical need to identify innovative strategies for providing them with information about the risks, benefits, and uncertainties of screening and the importance of IDM. Interactive communication technologies (ICTs) are increasingly being adopted by older adults. To assess whether a computer-based IDM intervention for PrCa screening would be effective for older AA men, this study examined their (1) PrCa risk and screening knowledge (2) decision-making processes for PrCa screening, and (3) usage of, attitudes toward, and access to ICTs. METHODS: A purposive sample of 39 AA men aged 40-65 years were recruited through faith-based organizations to participate in one of six 90-minute focus groups. Data were analyzed using open and axial coding techniques to identify relevant themes.

RESULTS: Participants were knowledgeable about PrCa. However, few engaged in IDM with their doctor about screening and almost none were informed about the risks and uncertainties. Most participants reported using ICTs on a daily basis for various purposes including health information seeking.

CONCLUSIONS: Because older AA men frequently use ICTs, researchers should consider IDM interventions that incorporate ICT. These interventions should provide information that will increase knowledge about PrCa screening and stress the importance of participating in IDM with their providers.