Prostate Cancer Survivor Outreach and Education Message Testing Study
Prostate cancer is the most commonly diagnosed cancer and the third most common cause of cancer deaths among American men. Racial disparities for prostate cancer are greater than for any other type of cancer. A combination of low knowledge of the disease, advanced stage at diagnosis and excessively high death marks the importance of African Americans as a priority group for prostate cancer prevention.
Strategies for the primary prevention of prostate cancer have not been found, and secondary prevention via prostate cancer screening remains debatable as there is no clear evidence that it decreases death. The controversy has led some leading medical groups to reject screening, while others call for efforts focused on informed decision-making. Despite the debate, screening among African-American men remains a strategy with potential for reducing disparities. High screening rates nationwide among all men and African-American men despite professional hesitation highlights a need for research about prostate cancer decision-making.
Building on community-based participatory research about prostate cancer care in the African-American community and in partnership with community organizations, this study developed and evaluated a message delivered through a survivor-led educational outreach program. It focused on prostate cancer risks, screening and treatment options. It included an informed decision-making process. This research enhances community-based promotion of prostate cancer decision-making and formalizes contributions of survivors in outreach activities.
The study sought answers to these questions:
- How can we effectively promote an informed decision-making process about prostate cancer screening, diagnosis and treatment in community-based educational outreach programs?
- How does survivor experience contribute to prostate cancer outreach programs and to the promotion of a decision-making process?
- What are the effects of exposure to the outreach program on understanding of prostate cancer, screening risks and benefits, and confidence in decision-making? And does survivor experience enhance such understanding and confidence?
The project found an upward trend in prostate cancer screening knowledge after the education program. Minimal changes were noted in prostate cancer screening beliefs except for a notable increase in screening self-efficacy (perceived self-confidence for completing screening). The outreach message was considered more culturally appropriate when delivered by survivors compared to when delivered by health educators. Finally, survivor educators were more appealing to study participants, who identified with and liked these educators.
As the study was completed, it supported and informed ongoing outreach activities of local organizations engaged in prostate cancer education and screening activities in the St. Louis region. The study found that an outreach strategy designed through community-based participatory research positively influences prostate cancer screening knowledge, beliefs and self-efficacy.
Moving forward, the study team will use findings to frame the larger strategy for addressing and communicating the screening controversy. It will expand on the potential of using prostate cancer survivors as educators and formalize their role in community outreach and informed decision-making.
Ricardo Wray, PhD (Primary Investigator, Saint Louis University)
Graham Colditz, MD, DrPH (Co-Investigator, Washington University)
Dione Farria, MD, MPH (Co-Investigator, Washington University)
Matthew Kreuter, PhD, MPH (Mentor, Washington University)
Nancy Weaver, PhD, MPH (Co-Investigator, Saint Louis University)
Keri Jupka, MPH (Project Manager, Saint Louis University)
Santosh Vijaykumar, (Research Assistant, Saint Louis University)
Ricardo Wray, PhD