Prostate cancer screening in African American and Caribbean males: detriment in delay

ABNF Journal, The, Nov-Dec, 2004 by Yvonne D. Parchment

Insufficient information may be an obstacle to obtaining screening among Black men. Smith, DeHaven, Grundig, and Wilson (1997) found that in a sample of African American men, only approximately 19% scored relatively high on knowledge about prostate cancer. Based on a review of the literature, Kleier (2003) concluded that African Caribbean men lacked knowledge and had misconceptions of causality of the disease. However, Magnus (2004) found adequate levels of knowledge among African American, Caribbean and African men in the U.S. and no differences in knowledge levels between groups. Income and family history of prostate cancer, marital status, and education level have found to be related to knowledge of prostate cancer among African American and Caribbean men (Magnus, 2004; Smith et al., 1997)

Ajzen (1991) addresses the subject of perceived difficulty as a significant predictor of intentions and behavior. Shelton and colleagues (1999) suggest that fear and embarrassment have prevented many Black men from seeking screening, and Agho and Lewis (2001) reported that African American men do not have prostate cancer screening tests performed as often as Caucasian men due to their underlying tear that manipulating the prostate will interfere with a man's virility. ClarkeTasker and Wade (2002) further established that even though

African American men understood the importance of early detection they still had concerns about the effects on their sex life if they were diagnosed with cancer. These concerns may lead to procrastination or the decision not to have screening. At least one study has shown that fear of impotence was not a significant barrier to screening (Weinrich, Reynolds, Tingen, & Start, 2000).

RELEVANCE OF CULTURE

Research suggests that when working with ethnic minority populations, cultural sensitivity improves the chances that project goals will be attained. Message concept, source and channel have been found to be important factors influencing screening participation among African American men (Odedina, Scrivens, Emanuel, LaRose-Pierre, Brown, & Nash, 2004), and in an ethnically mixed educational intervention, African American men were found to have increased participation levels if they were exposed to a role model of their ethnicity (Weinrich et al., 1998). Reports exist of difficulties in recruiting and engaging African American men in research, however Woods, Montgomery, and Herring (2004) reported experiencing no difficulties with recruiting Black men because they included Afrocentric materials, encouraged participatory involvement of the target population, and ensured cultural sensitivity, with a caring, professional, and personalized ethnic approach.

Barbershops and churches represent well-defined targets for recruitment in Black communities. Hart and Bowen (2004) assessed the feasibility of partnering with barbershops in education campaigns and discovered that 96% of proprietors would allow clients to learn about prostate cancer in their shops. Another study in barbershops with Black men of American, African, and Caribbean heritage were able to obtain a 99% response rate among clients (Magnus, 2004).