An Integrative Personal Model of Prostate Cancer Disparity (PIPCaD Model) for African American Men: Development and Validation

PUBLIC ABSTRACT

Study Rationale: According to the American Cancer Society, 30,770 new prostate cancer cases and 5,050 prostate cancer deaths will be reported among African American men for 2005. With these numbers, prostate cancer leads in new cancer cases and is the second leading cause of cancer death in African American men. More disturbing is the fact that African American men have the highest incidence for prostate cancer and the highest prostate cancer mortality rate of any US ethnic/racial group. The good news is that prostate cancer death rates have been declining since the 1990s. The bad news is that African American men continue to experience significant prostate cancer morbidity and mortality disparity. Prostate cancer prevention and detection by African American men offer great steps toward combating this deadly disease. Unfortunately, few at-risk African American men actively participate in prostate cancer prevention and detection activities.

Study Objective: What behavioral factors influence the decision of African American men relative to prostate cancer prevention and detection? How do African American men's cultural beliefs and values impact their prevention and detection behavior? Are there any within group differences among African American men relative to prostate cancer prevention and detection? These are the questions that will be answered in this study. Once these questions are answered, culturally appropriate interventions can be developed and implemented to foster prostate cancer prevention and detection behavior in African American men. Ultimately, this will address the burden of prostate cancer in this community.

The primary goal of this study is to develop and validate an Integrative Personal Model of Prostate Cancer Disparity (PIPCaD model) for African American men through the following activities:

1. Recruit 40 African American men between the ages of 40 and 70 for focus group interviews to generate culturally sensitive and relevant items for African American men's cultural beliefs and values.

2. Pre-test the PIPCaD survey developed among 100 African American men between the ages of 40 and 70 to ensure that the items are culturally sensitive, relevant, and reliable.

3. Over one year, recruit 3,400 African American men between the ages of 40 and 70 at ethnic barber shops and prostate cancer forums for a survey study to:

a. Assess the behavior of African American men relative to prostate cancer prevention and detection.

b. Test the predictive validity of the PIPCaD model among a minimum of 3,000 African American men using causal model analysis.

c. Explore the within group socio-demographic differences that impact African American men's prostate cancer prevention and detection behavior.

The aims specified in this grant will be investigated in three steps using focus group discussion and survey methodology. The results from this study will increase the understanding of personal factors that affect prostate cancer prevention behavior and early detection activities by African American men.

Applicability of the research: As proposed by the US Army Medical Research and Materiel Command for the prostate cancer research program, we need innovative, high-impact research that will (1) prevent prostate cancer, (2) detect prostate cancer, (3) cure prostate cancer, and (4) improve the quality of life for individuals living with prostate cancer and for their families. The product of this application will provide a guide model for culturally relevant and effective intervention to promote prostate cancer prevention and detection in the African American community. Ultimately, this will help reduce the prostate cancer disparity experienced by this population by decreasing prostate cancer incidence and increasing prostate cancer survival. Our success in addressing prostate cancer health disparity depends on the appropriate dissemination of the results of this application to the scientific community and, more importantly, to the African American community. Our dissemination plan for the scientific community includes at least three presentations at national professional meetings, presentation at the PCRP awardees meeting, and the submission of two manuscripts for publication in peer reviewed journals. The dissemination plan for the community are: (i) Presentation of the summary of findings at the 2009 African American Men's Health Forum in Tampa and the 2009 African American Men's Health Summit in Orlando; (ii) Publication and public release of a guide brochure, "Do My Health and Cultural Beliefs Affect Prostate Cancer Prevention and Detection? Perspectives of African American Men." Our recent effort in disseminating health reports such as this (the Prostate Cancer Communication: Educating African-American Men -- Dos & Don'ts) was a great resource for health care providers, health educators, and researchers to assist them in communicating with African American men about prostate cancer screening, clinical trials, and treatment; (iii) Use of the local media to publicize study results; (vi) Publication of important information in the research program quarterly newsletter; (v) Consistent dialogue with major African American men's organizations, such as fraternities and local 100 Black Men groups to provide updates on our study findings; and (vi) Discussion of the study results' implications on the CancerLink television program developed by the Principal Investigator of this application.