Program Empowering Decision Making About Prostate Cancer Among African-American
Males: An Urban/Rural Initiative supported by a grant from the Health
Care Financing Administration # 20-90853/3,
goal of the project is to empower African-American males to make
their decisions regarding prostate cancer screening and treatment.
The methodology involves the development of a manual to train lay
persons, some of whom are prostate cancer survivors, to implement
educational sessions, in workshop format to African-American males
and their significant others and family members. The expected results
of the educational intervention are as follows:
awareness of issues relating to prostate cancer screening and
treatment among African-American adults in two target areas (one
of which was a rural area in the State of Delaware, and
the other was the City of Philadelphia in Pennsylvania);
of the improved feelings of empowerment for decision making about
prostate cancer screening and treatment;
on comparison data on outcomes of an educational intervention
program on prostate cancer for a group of rural and for a group
of urban African-American adults;
- Tested training
materials to prepare lay trainers for empowerment training at
the community level in the African-American community;
Virginia J. Smith and Dr. B. Marshall Henderson Co-Principal
Investigators for the proposed project served as co-principal investigators
for the part of the pilot program that was conducted by Lincoln
University. This project is operated in partnership with Delaware
State University, for implementation of the rural workshops.
During the first year of the HCFA funded project, a training manual
(Appendix A)was developed for lay trainers who were responsible
for conducting workshops sponsored by community based organizations,
religious organizations, labor unions/professional organizations,
and advocacy groups. Also during the first year, these lay trainers
were trained to use the manual, including administering pre-post
tests. A participant handout packet (Appendix B) was developed providing
a summary of the materials presented in the workshops. To date,
approximately 1200 persons have participated in community workshops.
eight percent of the participants were African-American. General
information about the participants is as follows:
||Mean - 49
about health practices of preliminary sample are as follows:
- those who have health insurance
- those who had health check in last year
- those who had health insurance and had health check in
- those who do not have health insurance and did not have
health check in last year
- those who have regular doctors or clinic
- those who have regular doctors or clinics and had health
checks last year
- those who do not have regular doctors or clinics and did
not have health checks in last year
analysis is in the preliminary stage. The preliminary results of
pre-post test of knowledge about prostate cancer issues showed that
the average pre test score was 60 points. The average post test
score was 79 points. The percentage increase in knowledge as determined
by the pre post test was 32%. This percentage increase is generally
confined to 4 questions that address information about screening
session interviews with a small sample of participants yielded data
that can be organized around three general themes as follows:
Reactions to Sessions and Perceived Benefit
there were varying degrees of enthusiasm, all participants felt
that some benefits had been obtained. Sample statements and comments
"I 'm glad
that I came to this."
really great information, because there was a lot of this that
I didn't know about."
"It was good,
serious information, but there was also some humor that helped
to get it across."
helped to hear the experiences of men who have had to deal with
prostate cancer and to know about some of the good and bad decisions
that they made."
Learnings and Insights
of the participants took something substantive away from the sessions.
This new information and/or insight covered areas having to do with
the disease process, causal factors, treatment, and lifestyle. Sample
statements are as follows:
"I had thought
that prostate cancer affected very old men. I didn't think that
I would have anything to worry about and I never thought about
know that I should find out whether or not my uncles had ever
had prostate cancer. I don't think so, but I should check it out."
reason, it shocked me to find out that there were so many doctors
with prostate cancer."
Motivation and Action
of the participants indicated that they were ready to take action
and make changes because of what they had learned in the sessions.
Some of the comments to this effect include:
to see my doctor immediately and make sure that I have frequent
screenings, even if the insurance plan won't cover them all, and
I'll have to pay myself."
"I have a
responsibility to my children and need to be aware of this for
avoided the rectal examination but now I know that I have to have
that and the PSA. I'd better make sure that happens."
"This is information
that I think I should pass on to my doctor, especially the high
risk for Black men."
conclusions are that many African-American men are not aware of
their risk for prostate cancer, and an educational intervention
can empower these men about decision making for testing and treatment
options. Limitations and problems with the pilot that were identified
so far include:
- Some men
stay away from workshops such as those provided because they would
prefer a more private setting for obtaining information about
was difficult and often the number of persons expected far exceed
the number that actually attended the sessions.
- The data
collected from the participants did not include information on
risk for prostate cancer.