Abstract: Prostate cancer is a significant health problem for African-American men intensified by low participation in screenings, clinical trials, and prospective cohort studies. Ten focus groups were conducted with African-American males and their female partners/spouses. Perceptions and knowledge about prostate cancer, as well as willingness to participate in screening and research studies were measured. Participants had a basic level of knowledge about prostate cancer, and the importance of education was a unified theme. Dialogue with targeted African-American men and their partners/spouses may increase awareness and retention in medical research, while influencing health promotion, education and behavior.
Key Words: Prostate Cancer, African American Males, Southern African American Males, Community Collaboration
Prostate cancer is the most common cancer in American males. It poses a particularly deadly threat to African Americans, who are 31 percent more likely than Caucasians to develop it, and more than twice as likely to die from it. In part, this is due to late detection of cancer and its spread beyond the prostate.
Earlier detection and treatment of cancer would be facilitated if African American men had higher rates of participation in prostate cancer screenings. Rates are especially low for older African Americans with lower incomes, inadequate health insurance, and fewer years of education (Harris, Gorelick, Samules, & Bemping, 1996). Participation in clinical trials and prospective cohort studies would also help, but awareness of and recruitment in research studies is low among African American males. Historically, prevention trials have not been successful in recruiting African Americans, and attrition after recruitment has been a further complication (Moinpour et al., 2000; Myers, 1999; Myers et al., 2000). While African Americans have increasingly positive attitudes toward cancer medical research (Hoyo et. al, 2003), they are ambivalent about clinical trials (Moinpour et al., 2000; Myers, 1999; Myers et al., 2000; Stallings, Ford, Simpson et al, 2000).
There is almost no research that investigates awareness, perceptions, and outreach among southern African American men (Fearing, Bell, Newton, & Lambert, 2000; Myers, Wolf, Balshem, Ross, & Chodak, 1994; Collins, 1997; Plowden, 1999). Our study aimed to: 1) investigate health behavior, education, and awareness in regard to prostate cancer; 2) explore factors that influence decisions to participate in screenings; 3) determine the feasibility of participation in a long term follow-up study, and 4) assess barriers and facilitators to participation in such studies.
Focus group methods may elicit ideas from people who are often missed by more traditional methods (Gettleman & Winkleby, 2000), and they have been successfully used in marketing and health research to generate hypotheses and uncover attitudes and opinions. We used focus groups with African American males diagnosed with prostate cancer and their partners / spouses to explore how they felt about their disease and possible participation in clinical or medical trials.
A series of 10 focus groups (6 male only and 4 female only) were conducted with African American patients who were seen at a local urology clinic, and who had an ICD-9 code of 185, were between the ages of 40-75 years and had been diagnosed with prostate cancer within the past 10 years. Potential participants who met the inclusion criteria were randomly selected from lists of such men generated by the urology clinic. They were initially telephoned by clinic staff, followed by a letter and phone call for focus group scheduling. Since partners' beliefs may influence men's decisions to participate in research studies, female partners of men were also recruited and interviewed in separate focus groups. The spouses/partners were contacted after the male participants had been selected and scheduled. …