Educating African American men about prostate cancer: the barbershop program

American Journal of Health Studies, Fall, 2004 by Luvenia W. Cowart, Betty Brown, Diana J. Biro

More specific feedback from barbershop owners and Council members has been useful and informative as well. We first had to adjust our proposed evaluation process: though the post-intervention focus group session with owners and Council members was scheduled as planned, owners were not able to attend due to changes in their work schedules or other conflicts. So we talked to them in person regarding their perceptions about the success of the educational program. All owners had very positive responses. Our findings concerning program participants over three rounds, which include the barbershop owners' feedback, are summarized below:

* African American men are interested in and willing to talk about prostate cancer.

* Prostate cancer educational programs are needed in the Greater Syracuse community.

* Most African American men we met are not knowledgeable about prostate cancer.

* Barbershops are an especially good place to find and educate African American men.

* African American men who have prostate cancer typically do not self-identify, so they suffer quietly and alone.

* African American men want to help other African American men learn about this disease.

* African American men learn about prostate cancer screening and testing most often from healthcare providers in industry, i.e., health offices in their workplace; and least often from primary care physicians and other mainstream healthcare providers.

* African American men appreciate the knowledge, caring, and caregiving provided on their behalf, and they encourage the continuation of educational programming.

* Educational programming about prostate cancer fosters reflection concerning friends and family members who now suffer from the disease or who have had the disease in the past.

* Most participants had not been tested for prostate cancer. With new knowledge, however, most of them expressed an interest in the screening process and early detection programs.

Our Barbershop team returns to each shop periodically between scheduled educational sessions to restock the prostate cancer literature and talk with owners about the program, addressing any questions they may have and continuing the dialogue about this disease among African American men. Interestingly, the barbers (both owners and the men they employ) have become advocates for the program and resources for helping to educate their customers. This community outreach effort goes on informally between our scheduled interventions.

DISCUSSION AND RECOMMENDATIONS

With three full rounds of this project behind us, we now have enough experience with the Barbershop Education Program to assess the key factors contributing to its success in Central New York, and to outline the challenges such initiatives present. This section describes what we learned in this project and provides some recommendations for applying that knowledge to other health education programs targeting minority populations.

FOCUS, STRUCTURE AND STRATEGIES

First, if we are to eliminate health disparities and provide effective health care to all Americans, it is imperative that interventions for African Americans and other minorities be culturally competent and relevant. Many people in these groups (especially men) may not be comfortable with the mainstream healthcare system, may lack adequate insurance and healthcare resources, and/or may have low literacy skills which impair their ability to read and understand traditional health information. Establishing credibility and trust is vitally important, and requires shaping the program to fit their needs, perceptions, sensitivities, and concerns.