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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2006 Aug;98(8):1286–1295.

Knowledge, beliefs and barriers associated with prostate cancer prevention and screening behaviors among African-American men.

Deborah E Blocker 1, LaHoma Smith Romocki 1, Kamilah B Thomas 1, Belinda L Jones 1, Ethel Jean Jackson 1, LaVerne Reid 1, Marci K Campbell 1
PMCID: PMC2569547  PMID: 16916126

Abstract

African-American men have the highest prostate cancer rates worldwide, and innovative efforts are needed to increase cancer prevention and screening behaviors among this population. Formative research was conducted to assess attitudes and behaviors linked to prostate cancer prevention activities that could be used to develop a culturally relevant intervention for an African-American church-based population. Four gender-specific focus groups were conducted with 29 men and women at two African-American churches in central North Carolina. Three primary themes emerged from the focus group discussions: culturally and gender-influenced beliefs and barriers about cancer prevention and screening; barriers related to the healthcare system: and religious influences, including the importance of spiritual beliefs and church support. These discussions revealed the importance of the black family, the positive influence of spouses/partners on promoting cancer screening and healthy behaviors, the roles of faith and church leadership, and beliefs about God's will for good health. These findings also revealed that there are still major barriers and challenges to cancer prevention among African Americans, including continued mistrust of the medical community and negative attitudes toward specific screening tests. Findings provide important insights to consider in implementing successful prostate cancer prevention interventions designed for church-based audiences.

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Selected References

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  1. Anai Satoshi, Pendleton John, Wludyka Peter, Williams Christopher, Nelms Leah, Pettaway Curtis, Rosser Charles J. Prostate cancer screening and detection in inner-city and underserved men. J Natl Med Assoc. 2006 Apr;98(4):515–519. [PMC free article] [PubMed] [Google Scholar]
  2. Barber K. R., Shaw R., Folts M., Taylor D. K., Ryan A., Hughes M., Scott V., Abbott R. R. Differences between African American and Caucasian men participating in a community-based prostate cancer screening program. J Community Health. 1998 Dec;23(6):441–451. doi: 10.1023/a:1018758124614. [DOI] [PubMed] [Google Scholar]
  3. Bogart Laura M., Bird Sheryl Thorburn, Walt Lisa C., Delahanty Douglas L., Figler Jacqueline L. Association of stereotypes about physicians to health care satisfaction, help-seeking behavior, and adherence to treatment. Soc Sci Med. 2004 Mar;58(6):1049–1058. doi: 10.1016/s0277-9536(03)00277-6. [DOI] [PubMed] [Google Scholar]
  4. Brown D. R., Gary L. E. Religious involvement and health status among African-American males. J Natl Med Assoc. 1994 Nov;86(11):825–831. [PMC free article] [PubMed] [Google Scholar]
  5. Campbell Jessica K., Canene-Adams Kirstie, Lindshield Brian L., Boileau Thomas W-M, Clinton Steven K., Erdman John W., Jr Tomato phytochemicals and prostate cancer risk. J Nutr. 2004 Dec;134(12 Suppl):3486S–3492S. doi: 10.1093/jn/134.12.3486S. [DOI] [PubMed] [Google Scholar]
  6. Campbell Marci Kramish, James Aimee, Hudson Marlyn A., Carr Carol, Jackson Ethel, Oakes Veronica, Demissie Seleshi, Farrell David, Tessaro Irene. Improving multiple behaviors for colorectal cancer prevention among african american church members. Health Psychol. 2004 Sep;23(5):492–502. doi: 10.1037/0278-6133.23.5.492. [DOI] [PubMed] [Google Scholar]
  7. Clarke G., Whittemore A. S. Prostate cancer risk in relation to anthropometry and physical activity: the National Health and Nutrition Examination Survey I Epidemiological Follow-Up Study. Cancer Epidemiol Biomarkers Prev. 2000 Sep;9(9):875–881. [PubMed] [Google Scholar]
  8. Cohen J. H., Kristal A. R., Stanford J. L. Fruit and vegetable intakes and prostate cancer risk. J Natl Cancer Inst. 2000 Jan 5;92(1):61–68. doi: 10.1093/jnci/92.1.61. [DOI] [PubMed] [Google Scholar]
  9. Conrad M. E., Brown P., Conrad M. G. Fatalism and breast cancer in black women. Ann Intern Med. 1996 Dec 1;125(11):941–942. doi: 10.7326/0003-4819-125-11-199612010-00026. [DOI] [PubMed] [Google Scholar]
  10. Dessio Whitney, Wade Christine, Chao Maria, Kronenberg Fredi, Cushman Linda E., Kalmuss Debra. Religion, spirituality, and healthcare choices of African-American women: results of a national survey. Ethn Dis. 2004 Spring;14(2):189–197. [PubMed] [Google Scholar]
  11. Dunlop Dorothy D., Manheim Larry M., Song Jing, Chang Rowland W. Gender and ethnic/racial disparities in health care utilization among older adults. J Gerontol B Psychol Sci Soc Sci. 2002 Jul;57(4):S221–S233. doi: 10.1093/geronb/57.4.s221. [DOI] [PubMed] [Google Scholar]
  12. Ellison C. G. Race, religious involvement and depressive symptomatology in a southeastern U.S. community. Soc Sci Med. 1995 Jun;40(11):1561–1572. doi: 10.1016/0277-9536(94)00273-v. [DOI] [PubMed] [Google Scholar]
  13. Erwin Deborah O. Cancer education takes on a spiritual focus for the African American faith community. J Cancer Educ. 2002 Spring;17(1):46–49. doi: 10.1080/08858190209528792. [DOI] [PubMed] [Google Scholar]
  14. Felix Aaron Kaytura, Levine David, Burstin Helen R. African American church participation and health care practices. J Gen Intern Med. 2003 Nov;18(11):908–913. doi: 10.1046/j.1525-1497.2003.20936.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Fisher Deborah A., Dougherty Karen, Martin Christopher, Galanko Joseph, Provenzale Dawn, Sandler Robert S. Race and colorectal cancer screening: a population-based study in North Carolina. N C Med J. 2004 Jan-Feb;65(1):12–15. [PubMed] [Google Scholar]
  16. Ford Marvella E., Vernon Sally W., Havstad Suzanne L., Thomas Shirley A., Davis Shawna D. Factors influencing behavioral intention regarding prostate cancer screening among older African-American men. J Natl Med Assoc. 2006 Apr;98(4):505–514. [PMC free article] [PubMed] [Google Scholar]
  17. Friedenreich Christine M., Orenstein Marla R. Physical activity and cancer prevention: etiologic evidence and biological mechanisms. J Nutr. 2002 Nov;132(11 Suppl):3456S–3464S. doi: 10.1093/jn/132.11.3456S. [DOI] [PubMed] [Google Scholar]
  18. Gilligan Timothy, Wang Philip S., Levin Raisa, Kantoff Philip W., Avorn Jerry. Racial differences in screening for prostate cancer in the elderly. Arch Intern Med. 2004 Sep 27;164(17):1858–1864. doi: 10.1001/archinte.164.17.1858. [DOI] [PubMed] [Google Scholar]
  19. Giovannucci Edward, Rimm Eric B., Liu Yan, Stampfer Meir J., Willett Walter C. A prospective study of tomato products, lycopene, and prostate cancer risk. J Natl Cancer Inst. 2002 Mar 6;94(5):391–398. doi: 10.1093/jnci/94.5.391. [DOI] [PubMed] [Google Scholar]
  20. Han Paul K. J., Coates Ralph J., Uhler Robert J., Breen Nancy. Decision making in prostate-specific antigen screening National Health Interview Survey, 2000. Am J Prev Med. 2006 Mar 23;30(5):394–404. doi: 10.1016/j.amepre.2005.12.006. [DOI] [PubMed] [Google Scholar]
  21. How Helen Y., Cook Curtis R., Cook Vernon D., Ralston Kathleen K., Greenwell Eileen R., Goldsmith Linda J., Spinnato Joseph A. The pattern of change in the lecithin/sphingomyelin ratio in patients with preterm premature rupture of membranes between 24 and 34 weeks' gestation. J Perinatol. 2002 Jan;22(1):21–25. doi: 10.1038/sj.jp.7210579. [DOI] [PubMed] [Google Scholar]
  22. Jemal Ahmedin, Murray Taylor, Ward Elizabeth, Samuels Alicia, Tiwari Ram C., Ghafoor Asma, Feuer Eric J., Thun Michael J. Cancer statistics, 2005. CA Cancer J Clin. 2005 Jan-Feb;55(1):10–30. doi: 10.3322/canjclin.55.1.10. [DOI] [PubMed] [Google Scholar]
  23. Jernigan J. C., Trauth J. M., Neal-Ferguson D., Cartier-Ulrich C. Factors that influence cancer screening in older African American men and women: focus group findings. Fam Community Health. 2001 Oct;24(3):27–33. doi: 10.1097/00003727-200110000-00005. [DOI] [PubMed] [Google Scholar]
  24. Kristal A. R., Cohen J. H. Invited commentary: tomatoes, lycopene, and prostate cancer. How strong is the evidence? Am J Epidemiol. 2000 Jan 15;151(2):124–130. doi: 10.1093/oxfordjournals.aje.a010177. [DOI] [PubMed] [Google Scholar]
  25. Magnus Marcia. Prostate cancer knowledge among multiethnic black men. J Natl Med Assoc. 2004 May;96(5):650–656. [PMC free article] [PubMed] [Google Scholar]
  26. Markens Susan, Fox Sarah A., Taub Bonnie, Gilbert Mary Lou. Role of Black churches in health promotion programs: lessons from the Los Angeles Mammography Promotion in Churches Program. Am J Public Health. 2002 May;92(5):805–810. doi: 10.2105/ajph.92.5.805. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. McRae M. B., Carey P. M., Anderson-Scott R. Black churches as therapeutic systems: a group process perspective. Health Educ Behav. 1998 Dec;25(6):778–789. doi: 10.1177/109019819802500607. [DOI] [PubMed] [Google Scholar]
  28. Mettlin C. J., Murphy G. P., Rosenthal D. S., Menck H. R. The National Cancer Data Base report on prostate carcinoma after the peak in incidence rates in the U.S. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998 Oct 15;83(8):1679–1684. doi: 10.1002/(sici)1097-0142(19981015)83:8<1679::aid-cncr24>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  29. Miller Elizabeth C., Giovannucci Edward, Erdman John W., Jr, Bahnson Robert, Schwartz Steven J., Clinton Steven K. Tomato products, lycopene, and prostate cancer risk. Urol Clin North Am. 2002 Feb;29(1):83–93. doi: 10.1016/s0094-0143(02)00020-4. [DOI] [PubMed] [Google Scholar]
  30. Mitchell Jim, Lannin Donald R., Mathews Holly F., Swanson Melvin S. Religious beliefs and breast cancer screening. J Womens Health (Larchmt) 2002 Dec;11(10):907–915. doi: 10.1089/154099902762203740. [DOI] [PubMed] [Google Scholar]
  31. Musick Marc A., House James S., Williams David R. Attendance at religious services and mortality in a national sample. J Health Soc Behav. 2004 Jun;45(2):198–213. doi: 10.1177/002214650404500206. [DOI] [PubMed] [Google Scholar]
  32. Ndubuisi S. C., Kofie V. Y., Andoh J. Y., Schwartz E. M. Black-white differences in the stage at presentation of prostate cancer in the District of Columbia. Urology. 1995 Jul;46(1):71–77. doi: 10.1016/S0090-4295(99)80162-9. [DOI] [PubMed] [Google Scholar]
  33. Norman A., Moradi T., Gridley G., Dosemeci M., Rydh B., Nyrén O., Wolk A. Occupational physical activity and risk for prostate cancer in a nationwide cohort study in Sweden. Br J Cancer. 2002 Jan 7;86(1):70–75. doi: 10.1038/sj.bjc.6600023. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Pereira Mark A., Kartashov Alex I., Ebbeling Cara B., Van Horn Linda, Slattery Martha L., Jacobs David R., Jr, Ludwig David S. Fast-food habits, weight gain, and insulin resistance (the CARDIA study): 15-year prospective analysis. Lancet. 2005 Jan 1;365(9453):36–42. doi: 10.1016/S0140-6736(04)17663-0. [DOI] [PubMed] [Google Scholar]
  35. Phillips J. M., Cohen M. Z., Moses G. Breast cancer screening and African American women: fear, fatalism, and silence. Oncol Nurs Forum. 1999 Apr;26(3):561–571. [PubMed] [Google Scholar]
  36. Potosky A. L., Miller B. A., Albertsen P. C., Kramer B. S. The role of increasing detection in the rising incidence of prostate cancer. JAMA. 1995 Feb 15;273(7):548–552. [PubMed] [Google Scholar]
  37. Powe B. D. Cancer fatalism among African-Americans: a review of the literature. Nurs Outlook. 1996 Jan-Feb;44(1):18–21. doi: 10.1016/s0029-6554(96)80020-0. [DOI] [PubMed] [Google Scholar]
  38. Ravenell Joseph E., Johnson Waldo E., Jr, Whitaker Eric E. African-American men's perceptions of health: a focus group study. J Natl Med Assoc. 2006 Apr;98(4):544–550. [PMC free article] [PubMed] [Google Scholar]
  39. Reid La Verne, Hatch John, Parrish Theodore. The role of a historically black university and the black church in community-based health initiatives: the project DIRECT experience. J Public Health Manag Pract. 2003 Nov;Suppl:S70–S73. doi: 10.1097/00124784-200311001-00012. [DOI] [PubMed] [Google Scholar]
  40. Richardson Joann T., Webster J. DeWitt, Fields Norma J. Uncovering myths and transforming realities among low-SES African-American men: implications for reducing prostate cancer disparities. J Natl Med Assoc. 2004 Oct;96(10):1295–1302. [PMC free article] [PubMed] [Google Scholar]
  41. Saha Somnath, Arbelaez Jose J., Cooper Lisa A. Patient-physician relationships and racial disparities in the quality of health care. Am J Public Health. 2003 Oct;93(10):1713–1719. doi: 10.2105/ajph.93.10.1713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Sanders E. C., 2nd New insights and interventions: churches uniting to reach the African American community with health information. J Health Care Poor Underserved. 1997 Aug;8(3):373–376. doi: 10.1353/hpu.2010.0628. [DOI] [PubMed] [Google Scholar]
  43. Schröder Fritz H., Erasmus M. C. Early detection of prostate cancer. What do we tell our patients? Can J Urol. 2006 Apr;13 (Suppl 2):37–42. [PubMed] [Google Scholar]
  44. Scientific Program Committee Physical activity across the cancer continuum: report of a workshop: review of existing knowledge and innovative designs for future research. Cancer. 2002 Sep 1;95(5):1134–1143. doi: 10.1002/cncr.10771. [DOI] [PubMed] [Google Scholar]
  45. Shankar Sharada, Selvin Elizabeth, Alberg Anthony J. Perceptions of cancer in an African-American community: a focus group report. Ethn Dis. 2002 Spring;12(2):276–283. [PubMed] [Google Scholar]
  46. Shelton P., Weinrich S., Reynolds W. A., Jr Barriers to prostate cancer screening in African American men. J Natl Black Nurses Assoc. 1999 Fall-Winter;10(2):14–28. [PubMed] [Google Scholar]
  47. Smith R. A., von Eschenbach A. C., Wender R., Levin B., Byers T., Rothenberger D., Brooks D., Creasman W., Cohen C., Runowicz C. American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001--testing for early lung cancer detection. CA Cancer J Clin. 2001 Jan-Feb;51(1):38–80. doi: 10.3322/canjclin.51.1.38. [DOI] [PubMed] [Google Scholar]
  48. Tannor Bernice B., Ross Louie. Physician-patient discussions about prostate-specific antigen test use among African-American men. J Natl Med Assoc. 2006 Apr;98(4):532–538. [PMC free article] [PubMed] [Google Scholar]
  49. Thrasher James F., Campbell Marci Kramish, Oates Veronica. Behavior-specific social support for healthy behaviors among african american church members: applying optimal matching theory. Health Educ Behav. 2004 Apr;31(2):193–205. doi: 10.1177/1090198103259184. [DOI] [PubMed] [Google Scholar]
  50. U.S. Preventive Services Task Force Screening for prostate cancer: recommendation and rationale. Ann Intern Med. 2002 Dec 3;137(11):915–916. doi: 10.7326/0003-4819-137-11-200212030-00013. [DOI] [PubMed] [Google Scholar]
  51. Van Ness Peter H., Kasl Stanislav V., Jones Beth A. Religion, race, and breast cancer survival. Int J Psychiatry Med. 2003;33(4):357–375. doi: 10.2190/LRXP-6CCR-G728-MWYH. [DOI] [PubMed] [Google Scholar]
  52. Weinrich S. P., Boyd M. D., Bradford D., Mossa M. S., Weinrich M. Recruitment of African Americans into prostate cancer screening. Cancer Pract. 1998 Jan-Feb;6(1):23–30. doi: 10.1046/j.1523-5394.1998.1998006023.x. [DOI] [PubMed] [Google Scholar]
  53. Wolff Marie, Bates Tovah, Beck Barbra, Young Staci, Ahmed Syed M., Maurana Cheryl. Cancer prevention in underserved African American communities: barriers and effective strategies--a review of the literature. WMJ. 2003;102(5):36–40. [PubMed] [Google Scholar]
  54. Woods V. Diane, Montgomery Susanne B., Herring R. Patti, Gardner Robert W., Stokols Daniel. Social ecological predictors of prostate-specific antigen blood test and digital rectal examination in black American men. J Natl Med Assoc. 2006 Apr;98(4):492–504. [PMC free article] [PubMed] [Google Scholar]
  55. Young Deborah R., Aickin Mikel, Brantley Phillip, Elmer Patricia J., Harsha David W., King Abby C., Stevens Victor J. Physical activity, cardiorespiratory fitness, and their relationship to cardiovascular risk factors in African Americans and non-African Americans with above-optimal blood pressure. J Community Health. 2005 Apr;30(2):107–124. doi: 10.1007/s10900-004-1095-7. [DOI] [PubMed] [Google Scholar]

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