We propose a project to reduce morbidity as related to health disparities in prostate cancer survivors by identifying disparities in symptom burden and their contributors among African American prostate cancer survivors. The limited research reported that patient-reported quality of life outcomes are worse in African American compared to White prostate cancer survivors. Most importantly, other critically important symptom burden outcomes are largely understudied and overlooked in minorities. Previous research suggests African American prostate cancer survivors likely experience signi?cant symptom burden for outcomes that are avoidable or treatable. The proposed project will address these critical public health concerns in the growing population of African American prostate cancer survivors.! This project aims to 1) Compare symptom burden between African American and White prostate cancer survivors, 2) Identify multilevel modi?able risk factors for worse symptom burden among both African American and White prostate cancer survivors, such as cultural, health behavior-related, psychosocial, and racial discrimination factors, and 3) Identify multilevel non-modi?able risk factors for worse symptom burden, such as genetic, clinical, treatment-related, and demographic factors. The risk factors we will study are informed by an adapted multilevel contextual model examining the levels of the person, social environment, and healthcare system.! This will be among the ?rst and most comprehensive studies we are aware of to compare symptom burden between African American and White prostate cancer survivors. It will be the ?rst we are aware of to identify modi?able and non-modi?able risk factors for worse symptom burden. These risk factor data will allow us to develop targeted interventions and identify high-risk individuals for monitoring and early intervention. In summary, this project's focus on identifying disparities and their risk factors supports the Healthy People 2020 goals of eliminating health disparities and improving quality of life in cancer survivors.
! This will be among the ?rst and most comprehensive studies we are aware of to compare symptom burden between African American and White prostate cancer survivors, and it will be the ?rst to identify modi?able and non-modi?able risk factors for symptom burden in this population. Identifying risk factors for these outcomes will 1) allow us to develop interventions that target risk factors using evidence-based approaches and 2) lead to development of early support interventions for survivors at greatest risk.
