Neha Vapiwala1, David Miller2, Brenda Laventure2, Kristina Woodhouse3, Sheila Kelly4, Jade Avelis4, Cordelia Baffic2, Rodney Goldston5, Karen Glanz4. 1. Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Boulevard, TRC 4 West, Philadelphia, PA, 19104, USA. vapiwala@pennmedicine.upenn.edu. 2. Department of Radiation Oncology, University of Pennsylvania, 3400 Civic Center Boulevard, TRC 4 West, Philadelphia, PA, 19104, USA. 3. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, USA. 5. JugHead Media, LLC, Philadelphia, PA, USA.
Abstract
BACKGROUND: Health disparities in prostate cancer (PC) are thought to reflect the complex interplay of socioeconomics, environment and biology. The potential impact of beliefs and perceptions about PC among Black and Latino populations on clinical disparities are not well understood. This qualitative study was conducted to assess current prevalent and pervasive stigma, beliefs and perceptions regarding PC among Blacks and Latinos living in a large metropolitan area, thereby identifying potentially modifiable barriers to care. METHODS: Qualitative data were collected through four separate focus groups of self-identified Black and Latino adult men and women living in Philadelphia to better understand their perceptions of PC diagnosis, screening and treatment. Each focus group was single-sex and conducted by racial/ethnic group in order to assess possible differences in beliefs about PC based on gender and racial/ethnic affiliation. Audio recordings were transcribed verbatim by trained research assistants and qualitative data analysis was conducted using modified grounded theory. RESULTS: There were a total of 34 participants: 19 Hispanics/Latinos and 15 Blacks, with equal numbers of men and women (n=17). Median age was 57 years (range: 18 to 85 years). Dominant themes that emerged with respect to PC diagnosis included the stigma surrounding this condition and the perceived role of an "unhealthy lifestyle" and certain sexual behaviors as risk factors for PC development. While the majority of participants acknowledged the importance of PC screening and early detection, discussion centered around the barriers to both the interest in seeking medical care and the likelihood of securing it. These barriers included misunderstanding of PC etiology, distrust of the medical profession, and financial/access limitations. Men expressed substantial confusion about PC screening guidelines. In the Black female group, the role of faith and religion in the course of disease was a major theme. Both Black and Latina females discussed the role of fear and avoidance around PC screening and treatment, as well as the prevalence of misinformation about PC in their familial and social communities. CONCLUSION: Black and Latino focus groups revealed the existence of cultural beliefs, misunderstandings and fears pertaining to PC which could influence health-related behaviors. Some themes were common across groups; others suggested racial and gender predilections. Future targeted efforts focused on directly addressing prevalent misperceptions among underserved communities in urban settings could help to improve health literacy and equity in PC outcomes in these populations.
BACKGROUND: Health disparities in prostate cancer (PC) are thought to reflect the complex interplay of socioeconomics, environment and biology. The potential impact of beliefs and perceptions about PC among Black and Latino populations on clinical disparities are not well understood. This qualitative study was conducted to assess current prevalent and pervasive stigma, beliefs and perceptions regarding PC among Blacks and Latinos living in a large metropolitan area, thereby identifying potentially modifiable barriers to care. METHODS: Qualitative data were collected through four separate focus groups of self-identified Black and Latino adult men and women living in Philadelphia to better understand their perceptions of PC diagnosis, screening and treatment. Each focus group was single-sex and conducted by racial/ethnic group in order to assess possible differences in beliefs about PC based on gender and racial/ethnic affiliation. Audio recordings were transcribed verbatim by trained research assistants and qualitative data analysis was conducted using modified grounded theory. RESULTS: There were a total of 34 participants: 19 Hispanics/Latinos and 15 Blacks, with equal numbers of men and women (n=17). Median age was 57 years (range: 18 to 85 years). Dominant themes that emerged with respect to PC diagnosis included the stigma surrounding this condition and the perceived role of an "unhealthy lifestyle" and certain sexual behaviors as risk factors for PC development. While the majority of participants acknowledged the importance of PC screening and early detection, discussion centered around the barriers to both the interest in seeking medical care and the likelihood of securing it. These barriers included misunderstanding of PC etiology, distrust of the medical profession, and financial/access limitations. Men expressed substantial confusion about PC screening guidelines. In the Black female group, the role of faith and religion in the course of disease was a major theme. Both Black and Latina females discussed the role of fear and avoidance around PC screening and treatment, as well as the prevalence of misinformation about PC in their familial and social communities. CONCLUSION: Black and Latino focus groups revealed the existence of cultural beliefs, misunderstandings and fears pertaining to PC which could influence health-related behaviors. Some themes were common across groups; others suggested racial and gender predilections. Future targeted efforts focused on directly addressing prevalent misperceptions among underserved communities in urban settings could help to improve health literacy and equity in PC outcomes in these populations.
Authors: Joke Beuten; Jonathan A L Gelfond; Jennifer L Franke; Korri S Weldon; Analisa C Crandall; Teresa L Johnson-Pais; Ian M Thompson; Robin J Leach Journal: Cancer Epidemiol Biomarkers Prev Date: 2009-06 Impact factor: 4.254
Authors: Christopher M Deibert; Sally Maliski; Lorna Kwan; Arlene Fink; Sarah E Connor; Mark S Litwin Journal: J Urol Date: 2007-05 Impact factor: 7.450
Authors: Christopher A Haiman; Gary K Chen; William J Blot; Sara S Strom; Sonja I Berndt; Rick A Kittles; Benjamin A Rybicki; William B Isaacs; Sue A Ingles; Janet L Stanford; W Ryan Diver; John S Witte; Stephen J Chanock; Suzanne Kolb; Lisa B Signorello; Yuko Yamamura; Christine Neslund-Dudas; Michael J Thun; Adam Murphy; Graham Casey; Xin Sheng; Peggy Wan; Loreall C Pooler; Kristine R Monroe; Kevin M Waters; Loic Le Marchand; Laurence N Kolonel; Daniel O Stram; Brian E Henderson Journal: PLoS Genet Date: 2011-05-26 Impact factor: 5.917
Authors: Christopher A Haiman; Gary K Chen; William J Blot; Sara S Strom; Sonja I Berndt; Rick A Kittles; Benjamin A Rybicki; William B Isaacs; Sue A Ingles; Janet L Stanford; W Ryan Diver; John S Witte; Ann W Hsing; Barbara Nemesure; Timothy R Rebbeck; Kathleen A Cooney; Jianfeng Xu; Adam S Kibel; Jennifer J Hu; Esther M John; Serigne M Gueye; Stephen Watya; Lisa B Signorello; Richard B Hayes; Zhaoming Wang; Edward Yeboah; Yao Tettey; Qiuyin Cai; Suzanne Kolb; Elaine A Ostrander; Charnita Zeigler-Johnson; Yuko Yamamura; Christine Neslund-Dudas; Jennifer Haslag-Minoff; William Wu; Venetta Thomas; Glenn O Allen; Adam Murphy; Bao-Li Chang; S Lilly Zheng; M Cristina Leske; Suh-Yuh Wu; Anna M Ray; Anselm J M Hennis; Michael J Thun; John Carpten; Graham Casey; Erin N Carter; Edder R Duarte; Lucy Y Xia; Xin Sheng; Peggy Wan; Loreall C Pooler; Iona Cheng; Kristine R Monroe; Fredrick Schumacher; Loic Le Marchand; Laurence N Kolonel; Stephen J Chanock; David Van Den Berg; Daniel O Stram; Brian E Henderson Journal: Nat Genet Date: 2011-05-22 Impact factor: 38.330