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

Our team was careful to adapt the educational format and material to African American men, providing a relatively simple presentation in a relaxed, informal style. When we could not find culturally sensitive material on prostate cancer for these men, we developed our own "ethnic," easy-to-read brochure; in addition, we made sure our referral information was dear, useful, and included contacts for those without health insurance. Our project team participants--nurse educators, Council volunteers, and barbers--are all African American. We chose a setting that was natural and "non-threatening" for our target population and brought the program to them without asking that they alter their normal routines. Using a video that was short, engaging, focused on African American men, and that contained culturally familiar music also worked very well: the video attracted the attention of men coming into the barbershops, raised their curiosity about prostate health, and provided some basic facts in an accessible manner. They were then better prepared to accept additional counseling and to ask questions about prostate cancer.

Community networking and positive publicity also proved helpful in reaching African American men and inspiring confidence in the program. Initially Council members played a key role in publicizing the barbershop project, and word of mouth continues to bring men of color to the scheduled sessions. But shortly after the "pilot" round (2001), the regional media began reporting on the program: articles and features appeared in newspapers, magazines, radio and television broadcasts, with some messages targeted specifically to the black community (e.g., Syracuse's minority paper PRIDE). Project team members also visited minority churches and other faith-based organizations to present information on prostate cancer and the barbershop initiative. Public support by church and community leaders helped gain acceptance among African Americans for messages about prostate cancer as well as credibility for our program.

A final structural issue entails how we approached and involved the barbershop owners. While it was not difficult to convince them of the significance and benefits of the program, most of them were concerned about possible disruptions to their business. The shops are small and owners wondered whether there would be enough space to display posters and brochures, as well as present educational sessions to individuals or small groups. They needed to be reassured that the program would pose no inconvenience to them, their employees, or their customers. We also were not successful in organizing a group orientation or a post intervention focus group. Minority owners have varying schedules, and are not used to attending public meetings in a different location. Written evaluations did not work well either. However, when we shifted our strategy from "group scheduling" and survey forms to one-on-one talks with owners at their shops, they gave us remarkable cooperation and good feedback. Being sensitive and responsive to their needs and perspectives helped us gain their trust and build positive relationships. These barbers now welcome us cordially, and fully support our prostate cancer education activities.