Educating African-American men about prostate cancer: impact on awareness and knowledge

doi:10.1016/S0090-4295(02)02144-1

Urology

Volume 61, Issue 2, February 2003, Pages 308-313

https://doi.org/10.1016/S0090-4295(02)02144-1 Get rights and content

Abstract

Objectives

To determine whether an education program on prostate cancer could improve awareness and knowledge among African-American men. African-American men have the world’s highest incidence of prostate cancer and more than twice the mortality compared with white men. Screening programs for prostate cancer have not been successful in attracting African-American participation. One explanation is a poor awareness and knowledge about the disease among this high-risk population.

Methods

We surveyed 900 African-American adults attending prostate cancer education seminars in community settings throughout Illinois between March 1998 and January 2001. Participants were asked to complete a multiple-choice questionnaire on topics related to prostate cancer. The main outcome measures were a change in awareness and knowledge of prostate cancer after the 1-hour educational seminar.

Results

The mean survey score improved from 26.0% before the seminar to 73.3% after it (P <0.0001). Every multiple-choice question was answered correctly more often after the seminar than before it. Increasing levels of education and income were associated with higher before and after scores (P <0.001). Men achieved a significantly greater score improvement (mean 48.1%) compared with women (mean 41.1%; P = 0.006). Previous screening for prostate cancer was reported by 23% of the participants. Using logistic regression analyses, higher levels of education and income correlated with higher rates of screening. After the seminar, 63.1% stated the intention to undergo screening.

Conclusions

Our results demonstrate that prostate cancer awareness and knowledge can improve dramatically after a 1-hour seminar on the topic. Additional studies to evaluate the long-term retention of knowledge and impact on behavior are warranted.

Section snippets

Material and methods

A 1-hour educational seminar on prostate cancer was developed, based on a pilot study carried out in 1997. The seminar covered general information about prostate cancer, including risk factors for the disease, early warning signs, controversies regarding screening, current treatments, and common myths. An important element of this initiative was the formal involvement of both lay and medical advisory panels in the development of the program content, format, and surveys. To maximize enjoyment,

Results

Forty-four seminars were held between March 1998 and January 2001 at 31 different locations throughout Illinois. These seminars were attended by 900 African-American adults. Participant characteristics are shown in Table II. The ratio of men to women was approximately 6:1. The number attending each seminar ranged from 3 to 58 individuals (mean 20). We included the surveys from 835 (93%) of the 900 attendees in the final analysis. The remaining 65 individuals did not complete the program

Comment

The risk of prostate cancer diagnosis among African-American men is 66% greater than among European-American men.19, 20 Furthermore, the disease is diagnosed at more advanced stages among African-American men, thereby reducing the possibility of curative treatment in this population.21

Although the etiology of these racial differences is currently under investigation, studies have shown that African-American men have less knowledge and more misconceptions about prostate cancer. Price et al.22

Conclusions

This program demonstrates that prostate cancer awareness and knowledge can improve dramatically after a 1-hour seminar on this topic. Although a number of challenges remain, this program represents one of the first systematically evaluated educational programs on prostate cancer awareness conducted specifically for African Americans. On the basis of the significant improvement in knowledge that was achieved, this approach appears to be at least one way to enhance the ability of African

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In a study involving 160 men with no history of prostate cancer, O'Dell et al. found that college graduates scored higher on a prostate knowledge questionnaire than those with a high school education or less [16]. Similarly, in a study involving 900 AA men and women, higher education was associated with higher scores on a prostate cancer knowledge survey [17]. The association between education and prostate knowledge may help explain findings of education as an influencer of treatment decision-making [18].
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Thus it has been suggested that while the population of Jamaica is becoming increasingly aware of PCa, there are no significant changes in the clinical status of patients at the time of their diagnosis, due to the lack of organized screening programs for PCa in Jamaica (Coard and Skeete, 2009). Previous studies have shown that health education interventions are able to increase the knowledge and awareness of PCa, increase the uptake of PCa screening by African American men (Myers et al., 2000; Wilkinson et al., 2003), and increase intent to screen by Jamaican men (McCree-Hale et al., 2012). In this study we implemented the evidence-based intervention by McCree-Hale et al. in a larger sample of men, with the intention to increase participants' knowledge about PCa and increase the intention of men in the four parishes of Western Jamaica to utilize PCa screening services.
To conduct and evaluate the impact of a theory-based health education intervention on awareness of prostate cancer and intention to screen among men in Western Jamaica and determine screening rates of men participating in the intervention at 6 months post-intervention. 454 men utilizing various clinics and hospitals in Western Jamaica completed an interviewer-administered pretest survey on general prostate cancer knowledge and intention to screen. Upon completing the pretest, participants observed a prostate cancer health education intervention and immediately completed a posttest survey. Statistically significant improvements in the percentage of correct responses between the pretest and posttest were evident (p < 0.05). Additionally, screening rates increased dramatically by 6 months post-intervention with over 33% of men receiving a prostate exam after participating in the educational intervention. The theory-based educational intervention increased participants' knowledge of prostate cancer, types of screening tests, frequency of screenings and risk factors and symptoms, and was effective in increasing screening rates among the men in Western Jamaica within 6 months post-intervention. This theory-based educational intervention may be replicated to promote awareness of prostate cancer and further increase screening rates in other areas of Jamaica and other developing countries.
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^☆: This study was supported in part by National Cancer Institute Grant R25-Ca71982 and the C.U.R.E. fund at the University of Chicago.

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Adult urologyEducating African-American men about prostate cancer: impact on awareness and knowledge☆

Abstract

Objectives

Methods

Results

Conclusions

Section snippets

Material and methods

Results

Comment

Conclusions

Urology

Am J Clin Nutr

Lancet

Cancer statistics, 2002

CA Cancer J Clin

Cancer surveillance seriesinterpreting trends in prostate cancer—part I: Evidence of the effects of screening in recent prostate cancer incidence, mortality, and survival rates

J Natl Cancer Inst

Stage at presentation and survival of white and black patients with prostate carcinoma

Cancer

Differences between African American and Caucasian men participating in a community-based prostate cancer screening program

J Commun Health

A comparison of prostate knowledge of African-American and Caucasian menchanges from prescreening baseline to postintervention

Cancer J Sci Am

Recruitment of African Americans into prostate cancer screening

Cancer Pract

Prostate carcinoma risk and allelic variants of genes involved in androgen biosynthesis and metabolism pathways

Cancer

A prospective study on intake of animal products and risk of prostate cancer

Cancer Causes Control

Adult urology
Educating African-American men about prostate cancer: impact on awareness and knowledge☆