Relative to other racial and ethnic groups, African American men have a higher prevalence of cancer of the prostate (CaP), are more likely to present with disease at later stages, often have more aggressive tumors, are more likely to die from CaP, and tend to be less knowledgeable about CaP risk and the potential harms and benefits of CaP screening. There is no national consensus on screening for CaP, but practice guidelines recommend educating men, especially high-risk men, about the benefits and harms of CaP screening to support men in making informed decisions about CaP screening. The proposed study aims to: (a) evaluate the efficacy of a tailored telephone intervention in increasing knowledge and skills among African American men related to making an informed choice about CaP screening, (b) identify mediators and moderators of the intervention, and (c) explore predictors of CaP screening to understand why men decide to screen or not. The target population is African American men between the ages of 45 - 70 years old enrolled in the 1199 National Benefit Fund, the health care insurance fund for the largest health care workers union in the United States. Five hundred eligible and consenting men will receive a print brochure on the advantages and limitations of CaP screening and will then be randomized to receive either tailored-telephone CaP screening education or placebo (attention control) telephone education about diet and cancer risk. The tailored-telephone education program is designed as a decision support intervention and is based on the Ottawa Framework of medical decision-making. Main study outcomes are CaP decision variables (patient decision conflict, congruence between patient values and CaP screening decision) and communication variables (patient discusses CaP with physician and shares in CaP screening decision). Other important outcomes include knowledge about CaP and screening, perceived decision support, and perceived efficacy to communicate with physician. Data will be collected through patient interviews, physician reports, and medical chart and claims review at baseline and 6 -months post-intervention. This proposal addresses the strong need to educate African American men about CaP screening as a way of enhancing individualized, informed and shared decision making regarding CaP screening. By ensuring that the intervention components are theoretically grounded, acceptable to the target population, feasible in terms of time, practical, and allow for individualization, the proposed intervention strategy has the potential to be widely disseminated if efficacy is demonstrated.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA104223-02
Application #
6929816
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Shaikh, Abdul R
Project Start
2004-09-01
Project End
2008-06-30
Budget Start
2005-09-01
Budget End
2006-06-30
Support Year
2
Fiscal Year
2005
Total Cost
$565,551
Indirect Cost
Name
Columbia University Teachers College
Department
Other Health Professions
Type
Schools of Education
DUNS #
071050983
City
New York
State
NY
Country
United States
Zip Code
10027
Lepore, Stephen J; Nair, Rasmi G; Davis, Stacy N et al. (2017) Patient and Physician Factors Associated with Undisclosed Prostate Cancer Screening in a Sample of Predominantly Immigrant Black Men. J Immigr Minor Health 19:1343-1350
Lepore, Stephen J; Wolf, Randi L; Basch, Charles E et al. (2012) Informed decision making about prostate cancer testing in predominantly immigrant black men: a randomized controlled trial. Ann Behav Med 44:320-30
Godino, Job G; Lepore, Stephen J; Rassnick, Stefanie (2010) Relation of misperception of healthy weight to obesity in urban black men. Obesity (Silver Spring) 18:1318-22
Collins, Bradley N; Lepore, Stephen J (2009) Association between anxiety and smoking in a sample of urban black men. J Immigr Minor Health 11:29-34
Wolf, Randi L; Lepore, Stephen J; Vandergrift, Jonathan L et al. (2009) Tailored telephone education to promote awareness and adoption of fruit and vegetable recommendations among urban and mostly immigrant black men: a randomized controlled trial. Prev Med 48:32-8
Wolf, Randi L; Lepore, Stephen J; Vandergrift, Jonathan L et al. (2008) Knowledge, barriers, and stage of change as correlates of fruit and vegetable consumption among urban and mostly immigrant black men. J Am Diet Assoc 108:1315-22