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

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

Churches (with the involvement of parish, church or Christian nurses) have been an effective forum for disseminating health education and information to the community. Plowden (1999), Mann and others (2000), and Satcher (2000), found that church members were better able to relate to health professionals in a culturally and socially compatible manner in a church setting. The congregants reported appreciating that the professionals in the church spent time listening to them as well as teaching them about health issues. Lambert, Fearing, Bell, and Newton (2002) studied health beliefs in African American men and found that reliance on their faith encouraged them to participate in health promotion activities. Certain characteristics may have accounted for an increase in effective recruitment and scheduling techniques in a church setting. These included using churches that had a means of communication in place, establishing rapport with leaders in the churches, and using a variety of educational methods and materials in the educational programs (Weinrich, Boyd, Weinrich, Greene, Reynolds, & Metlin, 1998).

The purpose of this study was to investigate the health beliefs about prostate health in a sample of African American and Caribbean men in Miami-Dade, Florida, and to determine if an educational program would lead to an increase in prostate screenings. It was hypothesized that community-based education about the importance of early detection would lead to an increase in health screenings by the men in the sample. This paper presents preliminary findings from the first phase of the study investigating health beliefs and initial results from the educational seminars.

THEORETICAL FRAMEWORK

The Theory of Reasoned Action (TRA) was used as a basis for testing the proposed intervention (Fishbein & Ajzen, 1975; Becker, Randall, & Riegel, 1995). Researchers across disciplines, including nursing, psychology and medicine, have used this theory to describe health related behavioral change (Shelton et al., 1999; Becker & Gibson, 1998; Trafimow & Trafimow, 1998; Hopkins, Hopp, & Hopp, 1998: Savage & Clarke, 2001). According to the TRA, people act in accordance with their intentions to perform a specific behavior. Intentions are influenced by attitudes toward the behavior, subjective norms and perceptions of behavioral control. The TRA therefore proposes that behavior can be predicted from behavioral intentions, attitudes, and subjective social norms (Becker & Gibson, 1998).

Fishbein and Ajzen (1975) describe attitude as 'a learned predisposition to respond in a consistently favorable or unfavorable manner with respect to a given object.' Behavioral intention is described by these authors as 'a special case of beliefs, in which the object is always the person himself and the attribute is behavior.' The strength of intention is indicated by the person's subjective probability that he will perform the behavior in question. This theory is suited for use in the proposed study, as the aim of this study is to ascertain the level of participation of Black men in prostate cancer screening activities, based on their beliefs/attitudes. The theory predicts that attitudes and behavioral intentions will be influenced by accessibility to health care, health beliefs about screenings and fear of screening.