Patterns of Information Behavior and Prostate Cancer Knowledge Among African-American Men

The purposes of this study are to explore cancer information acquisition patterns among African-American men and to evaluate relationships between information acquisition patterns and prostate cancer prevention and control knowledge. A random sample of 268 men participated in a statewide interviewer-administered, telephone survey. Men classified as non-seekers, non-medical source seekers, and medical source seekers of prostate cancer information differed on household income, level of education, and beliefs about personal risk for developing prostate cancer. Results from multiple regression analysis indicated that age, education, and information-seeking status were associated with overall levels of prostate cancer knowledge. Results from logistic regression analyses indicated that men who included physicians as one of many information resources (medical source seekers) had superior knowledge over non-seekers and non-medical source seekers on 33% of individual knowledge details. The findings emphasize the need to connect lower-income and lower-educated African-American men to physicians as a source of prostate cancer control information

Implementation of the Online Assessment to Study Information Seeking (OASIS): A Feasibility Study

Background: Technology has provided new and interesting platforms for conducting survey research. However, computerized surveys are not widely used in men\u27s health studies. Purpose/Objectives: The purpose of this research was to explore the feasibility of conducting a computerized survey with prostate cancer patients in an urban cancer center. The objectives were to identify and resolve issues surrounding participant recruitment and survey implementation during clinic hours. Methods/Approach: Men were eligible to participate if they: a) had been treated for localized prostate cancer within the past 5 years, b) self-identified as African American (AA) or White, and c) were 18 years of age or older. All eligible participants were invited to complete the 90-item semi-structured survey by two AA men. The survey was created using Articulate Quizmaker software and published onto a password-protected website. Men completed the survey on a laptop computer in the exam room during their scheduled follow-up consultations. The survey captured patient demographics, cancer treatment information and psycho-social characteristics. Results:Thirty-three surveys were completed between February 2013 - April 2013. All surveys were completed in one sitting. Participants were White (73%) and AA (27%). The majority of patients approached (Whites 89%, AAs 100%) agreed to participate. Participants\u27 mean age was 62 years (range: 48 - 84 years). The mean time required to complete the survey was 29 minutes (range: 14 - 61 minutes). Survey completion time did not vary by race or age. The initial recruitment strategy produced more than the targeted number (N=15) of White patients, but an insufficient number of AAs. Conclusions: The results indicate that computerized surveys can be implemented into an active, urban urology clinic during patient treatment follow-up visits. Although White and AA men are willing to participate in these kinds of studies, identifying sufficient numbers of eligible AA men is a problem. Barriers encountered during the feasibility testing and solutions that were implemented will be presented. Next steps of this research include identifying appropriate recruitment and implementation strategies to engage prostate cancer patients from community clinics in rural settings

Beyond biology: the impact of marital status on survival of patients with adrenocortical carcinoma

Purpose: To analyze the association of marital status and survival of patients with ACC using a population-based database. Material and Methods: Patients with ACC were abstracted from the Surveillance Epidemiology and End Results (SEER) database from 1988-2010 (n=1271). Variables included marital status (married vs single/divorced/widowed (SDW)), gender, age, race, tumor (T) and node (N) classification, receipt of surgery, and SEER stage. Statistical analysis was performed using Cox proportional hazard models to generate hazard ratios and 95% confidence intervals. Results: There were 728 (57.3%) females and median age was 56 years (IQR 44-66). Patients who were alive were more frequently married (65.6% vs 61.6%, p=0.008), female (61.1% vs 58.0%, p=0.001), younger (median 51 vs 57 years, p=0.0001), submitted to adrenalectomy (88.6% vs 63.8%, p<0.0001), and more favorable SEER stage (localized-64.9% vs 29.9%; regional–25.1% vs 30.1%; distant 4.8% vs 31.5%, p<0.0001) compared to patients dead of disease (DOD). On multivariable analysis, factors significantly associated with all-cause mortality were SDW status (HR 1.28, 95% CI 1.091.51), age, non-operative management, and N+ disease. Risk factors for disease-specific mortality included SDW status (HR 1.30, 95% CI 1.07-1.56), age, non-operative management, T-classification, and N+ disease. Conclusions: Marital status is significantly associated with survival in patients with ACC. Our results suggest that the decreased survival seen among SDW individuals highlights an area for further research and needed intervention to reduce disparity

Using CBPR to Extend Prostate Cancer Education, Counseling, and Screening Opportunities to Urban-Dwelling African-Americans

Community-based participatory research (CBPR) is becoming one of the dominant approaches for bringing evidence- and consensus-based cancer prevention and control practices to medically underserved communities. There are many examples of how CBPR has been useful for generating culturally specific solutions for different health issues that affect African-Americans. However, few examples exist in the literature on how the CBPR approach can be applied to address prostate cancer. This paper describes a collaborative process for linking inner-city, African-American men to free prostate cancer education, physician counseling, and screening opportunities (prostate-specific antigen (PSA) testing and digital rectal examination (DRE)). The site of this community-based participatory project was the city of Buffalo, located in Erie County, New York. The collaborative, community-academic process that is described includes the following: (1) planning and conducting a community needs assessment to contextualize local prostate cancer issues, (2) organizing town and gown event planning, and (3) manipulating aspects of the built environment to build an infrastructure within the community to address disparities in screening opportunities. This paper concludes with a description of lessons learned that can help others develop and implement similar activities in other communities