Prostate Cancer Screening – Spiritually Based vs. Non-Spiritually Based
This pilot study examined the efficacy of a spiritually based educational intervention for increasing informed decision making for prostate cancer screening among African-American men. The intervention appeared to be effective for some study outcomes, such as knowledge and self-efficacy for screening informed decision making.
Introduction: Health communication interventions have been modestly effective for increasing informed decision making for prostate cancer screening among African-American men; however, knowledge and informed decision making is still questionable even with screening. Church-based programs may be more effective if they are spiritually based in nature.
Objective: The aims of the present study were to implement and provide an initial evaluation of a spiritually based prostate cancer screening informed decision making intervention for African-American men who attend church, and determine its efficacy for increasing informed decision making.
Design and Method: Churches were randomized to receive either the spiritually based or the non-spiritual intervention. Trained community health advisors, who were African-American male church members, led an educational session and distributed educational print materials. Participants completed baseline and immediate follow-up surveys to assess the intervention impact on study outcomes.
Results: The spiritually based intervention appeared to be more effective in areas such as knowledge, and men read more of their materials in the spiritually based group than in the non-spiritual group.
Conclusions: Further examination of the efficacy of the spiritually based approach to health communication is warranted.
Level of Evidence - II ( Melnyk & Fineout-Overholt, 2005)
In the United States, prostate cancer is the leader in male cancer incidence and is second in cancer mortality (American Cancer Society [ACS], 2008). The disease takes a particularly high toll among African-American men who are 60% more likely to develop prostate cancer and twice as likely to die from the disease as are European-American men (Stanford et al., 1999). The National Institute on Aging's (2000) strategic plan on health disparities recognized that African-American men suffer from prostate cancer more than other men, and called for culturally appropriate strategies and interventions aimed at decreasing this disparity.
Consistent with the idea that informed decision making is more than just knowledge (Bowen et al., 2006), informed decision making is conceptualized as being composed of a variety of factors, including knowledge of the disease, knowledge of the relationship between screening and mortality, knowledge of the controversy regarding screening, beliefs regarding screening for the disease, self-efficacy for screening, and preparation for and stage of decision making regarding screening. Appropriate interventions in this context include offering screening and encouraging the man to make an informed decision about screening that is right for him based on his risk profile and values.
Educational interventions are one approach to increasing informed decision making for prostate cancer screening. Sometimes called decision aids, such educational programs should address cultural beliefs if they are to be maximally effective (Chan et al., 2003). They should also be developed using community-based methods in which the priority population is involved in every stage from intervention planning to implementation and evaluation (Woods, Montgomery, & Herring, 2004). A community approach is suggested to be more appropriate than a provider or health system-based approach for reaching African-American men with prostate cancer information (Weinrich, Boyd, Bradford, Mossa, & Weinrich, 1998).
The church is often used as an access point to reach African Americans with health information. Several church-based efforts have been effective for increasing prostate cancer knowledge and/or screening among African-American men (Boehm et al., 1995; Tingen, Weinrich, Heydt, Boyd, & Weinrich, 1998; Weinrich Holdford et al., 1998; Wilkinson, List, Sinner, Dai, & Chodak, 2003).
Abstract and Introduction
Abstract
This pilot study examined the efficacy of a spiritually based educational intervention for increasing informed decision making for prostate cancer screening among African-American men. The intervention appeared to be effective for some study outcomes, such as knowledge and self-efficacy for screening informed decision making.
Introduction: Health communication interventions have been modestly effective for increasing informed decision making for prostate cancer screening among African-American men; however, knowledge and informed decision making is still questionable even with screening. Church-based programs may be more effective if they are spiritually based in nature.
Objective: The aims of the present study were to implement and provide an initial evaluation of a spiritually based prostate cancer screening informed decision making intervention for African-American men who attend church, and determine its efficacy for increasing informed decision making.
Design and Method: Churches were randomized to receive either the spiritually based or the non-spiritual intervention. Trained community health advisors, who were African-American male church members, led an educational session and distributed educational print materials. Participants completed baseline and immediate follow-up surveys to assess the intervention impact on study outcomes.
Results: The spiritually based intervention appeared to be more effective in areas such as knowledge, and men read more of their materials in the spiritually based group than in the non-spiritual group.
Conclusions: Further examination of the efficacy of the spiritually based approach to health communication is warranted.
Level of Evidence - II ( Melnyk & Fineout-Overholt, 2005)
Introduction
In the United States, prostate cancer is the leader in male cancer incidence and is second in cancer mortality (American Cancer Society [ACS], 2008). The disease takes a particularly high toll among African-American men who are 60% more likely to develop prostate cancer and twice as likely to die from the disease as are European-American men (Stanford et al., 1999). The National Institute on Aging's (2000) strategic plan on health disparities recognized that African-American men suffer from prostate cancer more than other men, and called for culturally appropriate strategies and interventions aimed at decreasing this disparity.
Consistent with the idea that informed decision making is more than just knowledge (Bowen et al., 2006), informed decision making is conceptualized as being composed of a variety of factors, including knowledge of the disease, knowledge of the relationship between screening and mortality, knowledge of the controversy regarding screening, beliefs regarding screening for the disease, self-efficacy for screening, and preparation for and stage of decision making regarding screening. Appropriate interventions in this context include offering screening and encouraging the man to make an informed decision about screening that is right for him based on his risk profile and values.
Educational interventions are one approach to increasing informed decision making for prostate cancer screening. Sometimes called decision aids, such educational programs should address cultural beliefs if they are to be maximally effective (Chan et al., 2003). They should also be developed using community-based methods in which the priority population is involved in every stage from intervention planning to implementation and evaluation (Woods, Montgomery, & Herring, 2004). A community approach is suggested to be more appropriate than a provider or health system-based approach for reaching African-American men with prostate cancer information (Weinrich, Boyd, Bradford, Mossa, & Weinrich, 1998).
The church is often used as an access point to reach African Americans with health information. Several church-based efforts have been effective for increasing prostate cancer knowledge and/or screening among African-American men (Boehm et al., 1995; Tingen, Weinrich, Heydt, Boyd, & Weinrich, 1998; Weinrich Holdford et al., 1998; Wilkinson, List, Sinner, Dai, & Chodak, 2003).
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