Fostering shared decision-making about prostate cancer screening among African American men patients and their primary care providers: a randomized behavioral clinical trial.

BACKGROUND: Prostate cancer is the third most prevalent cancer in the American population. Furthermore, the prognosis is worse in African American as there is increased morbidity and mortality associated with it. PURPOSE: The purpose of this study is to evaluate the effectiveness of a new online method to educate the patient population regarding prostate cancer risk, diagnosis, treatments, and their decisions about whether to be screened for the early detection of prostate cancer. METHODS: Two hundred Black male patients are recruited from different clinical sites and randomized to either the control arm (usual care) or the intervention arm (educational program). We will compare the effectiveness of the intervention to see if patients are discussing the need of getting a prostate-specific antigen (PSA) test, and the possible benefits and harms that may result of having or not having the test, with their primary care providers. DISCUSSION: Shared decision-making (SDM) is the current standard in most cancer-screening guidelines and also a standard of person-centered care. However, there is a lack of evidence-based approaches to improve decision quality in clinical settings and an increased ambiguity of applying SDM for PSA-based screening among Black men in primary care. Our proposal to evaluate a decisional-aid intervention and measure the actual application of SDM during clinical encounters has a high potential to advance the translation path of implementing shared decision-making in clinical settings and provide evidence of the applicability of the guideline in general. INNOVATION AND OVERALL IMPACT: Given the 2018 USPSTF updated guidelines recommending shared decision-making about PSA-based screening, the increased risk of prostate cancer mortality in Black men, the challenges of evidence-based decision-making due to the underrepresentation of Blacks in major randomized clinical trials, and implicit racial bias among primary care providers, the time is ripe for interventions to improve shared decision-making about prostate cancer screening in Black men. In this study, we address communication and knowledge gaps between Black men and their primary care providers. The intervention, if proven effective, can be readily scaled across primary care practices across the U.S. and may be adapted to other types of cancer where guidelines have included shared decision-making as well. Early detection of prostate cancer may decrease mortality and morbidity in the long term.

Understanding What Influences Sexual Health Behaviors among Black Males in College.

Using the Health Belief Model as a guide, focus groups and interviews (n=35) were conducted with Black males at a Historically Black College and University. Findings suggest that norms around the expectations of men and sex relates to their sexual behavior. The study also indicates that while Black college men know they should engage in protected sex (perceived benefits), they are inclined to engage in unprotected sex if their partner is on the pill (cues to action), they don't believe the consequences are immediate (perceived severity), and they like the feel of not using a condom (perceived barriers).

Grown woman: Understanding what influences health behaviors in black female students at a HBCU.

Objective: The purpose of this study was to understand what influences health behaviors in Black female students at a Historically Black College and University (HBCU).Participants and Methods: Twenty-five Black female students enrolled at a HBCU in the southern United States participated in five focus groups and one interview. Qualitative analysis was used to analyze data for similar themes and codes.Results: The three areas that appear to influence health behaviors are interpersonal, community, and society.Conclusions: These findings highlight the need for HBCUs to develop health programs for Black women on their campus that include elements of interpersonal support. Additionally, HBCUs need to work on how they create an environment that provides their female students with the resources they need to be able to live a healthy life.

Black College Women and the Health of Black College Men.

The purpose of this study was to understand the influence Black college women have on the health behaviors of Black men. Using the Health Belief Model and the socioecological model as guides, focus groups and interviews were conducted with Black college men (n = 35) and Black college females (n = 25) at a Historically Black College and University in the Southern United States. Participants provided responses to questions on what impacts their health behaviors and whose health they influence. Results indicate that Black college men believed Black peer women influence decisions they make regarding their diet, physical activity, and general health behaviors. However, Black college women believe they only influenced physical activity and sexual health in Black college men. While they understood they had some influence on their health, the women were unsure if they had long-term influence. These findings highlight the need for programming that informs young Black women on the important role they play in the health of men in their lives, particularly young Black men. These findings also highlight the need for peer health educator training to cross-train educators on health issues of all gender groups.