African American men and informed prostate cancer-related decision making: Developing valid measures

BACKGROUND: African-American (AA) men experience significantly higher prostate cancer (PrCA) incidence and mortality rates than do European-American men. AA men in South Carolina have the highest PrCA mortality rates in the United States. In order to effectively create and implement interventions to reduce PrCA disparities, we developed and pilot-tested a survey measuring whether, and to what extent, AA men in South Carolina are: 1) learning about PrCA screening, treatment, and survival and 2) engaging in informed decision making about PrCA screening and treatment as recommended by the American Cancer Society.

METHODS: A 45-item survey (to be administered statewide) containing demographic, knowledge, and behavioral questions was developed based on existing instruments. A purposive, convenience sample of 35 AA men 40-74 years of age were recruited to participate in one of two 90-minute group-based cognitive interviews where they completed the survey and provided feedback regarding the format, readability, and content of each survey question.

RESULTS: All participants were instrumental to the discussion and provided valuable feedback on each question. Approximately 34 of the questions were modified. Overall, men felt that the format and content of the questions were appropriate. Specific changes such as changing word selection (e.g., friend vs. acquaintance) enhanced question readability.

CONCLUSIONS: In order to create culturally appropriate survey instruments researchers should consider pilot-testing their instruments among a small subset of their target population. Coordinating forums where the community can be involved in early phases of the research process can increase rapport and establish trust between communities and researchers.