Introduction: The only racial/ethnic group that has not met the Healthy People 2010 goal for the nation relating to prostate cancer (CaP) is African American Men (AAM). With the differences in CaP morbidity and mortality experienced by AAM compared to other racial groups, there is significant CaP health disparity for AAM. Given that behavioral choices is arguably the most influential determinant of population health, accounting for about 40%, it is important to target individual behavior in the effort to eliminate health disparity. Thus, our study objective was to develop and validate an Integrative Personal Model of Prostate Cancer Disparity (PIPCaD) model for AAM. We identified factors that directly influence AAM9s CaP prevention and detection activities, with the goal to develop effective interventions that will address this disparity. Materials and Methods: After generating the items for the PIPCaD survey through focus group interviews, the PIPCaD survey was pre-tested among 100 AAM to ensure that the items were culturally sensitive, relevant and reliable. Subsequently, AAM between the age of 40 and 70 were recruited at ethnic barber shops, churches and CaP forums to participate in a cross-sectional survey study to: (a) Assess the behavior of AAM relative to CaP prevention and detection; and (b) Test the predictive validity of the proposed PIPCaD model. The usual descriptive statistics and multiple regression analyses were employed for the study analyses. Results: Four hundred and twenty-four (424) AAM were recruited for the study, comprising mostly AAM between 40 and 49 years, college educated, married, with full-time employment, and earning between $40,000 and $59,999. Based on mean statistics and frequency analyses, most of the men have moderately good eating behavior, consistently seek information about CaP, have moderate exercise schedule and hardly consume supplements to prevent CaP. About 24% received only DRE or PSA within the past year and 31% had both tests. The following variables were significantly associated with a composite index of CaP prevention and detection behavior, explaining 45% of the variance: CaP knowledge, perceived behavioral control, cues to action, CaP fatalism, temporal orientation and full-time employment. We also found that: (i) perceived behavioral control determined eating behavior; (ii) employment, cues to action and acculturation determined supplement consumption; (iii) education, religiosity and perceived behavioral control determined physical activity; (iv) perceived behavioral control, cues to action, acculturation and knowledge determined seeking CaP information; and (v) household income, perceived susceptibility, and cues to action determined CaP screening. Conclusion: Undoubtedly, the health behavior of AAM contributes to CaP health disparity. Our study is the first one to confirm the cognitive-behavioral factors and cultural beliefs and values that affect AAM9s CaP prevention behavior. This study is of significant importance in the African American community given the powerful impact of cultural and health beliefs on health promotion and disease prevention. Based on the modifiable factors found to impact behavior in this study, appropriate effective, culturally sensitive and relevant interventions can be developed to promote CaP prevention and early detection among AAM.
Introduction The Florida-California Cancer Research, Education, and Engagement (CaRE 2 ) Health Equity Center is a triad partnership committed to increasing institutional capacity for cancer disparity research, the diversity of the cancer workforce, and community empowerment. This article provides an overview of the structure, process innovations, and initial outcomes from the first 4 years of the CaRE 2 triad partnership. Methods CaRE 2 serves diverse populations in Florida and California using a “molecule to the community and back” model. We prioritize research on the complex intersection of biological, environmental, and social determinants health, working together with scientific and health disparities communities, sharing expertise across institutions, bidirectional training, and community outreach. Partnership progress and outcomes were assessed using mixed methods and four Program Steering Committee meetings. Results Research capacity was increased through development of a Living Repository of 81 cancer model systems from minority patients for novel cancer drug development. CaRE 2 funded 15 scientific projects resulting in 38 publications. Workforce diversity entailed supporting 94 cancer trainees (92 URM) and 34 ESIs (32 URM) who coauthored 313 CaRE 2 -related publications and received 48 grants. Community empowerment was promoted via outreaching to more than 3000 individuals, training 145 community cancer advocates (including 28 Community Scientist Advocates), and publishing 10 community reports. CaRE 2 members and trainees together have published 639 articles, received 61 grants, and 57 awards. Conclusion The CaRE 2 partnership has achieved its initial aims. Infrastructure for translational cancer research was expanded at one partner institution, and cancer disparities research was expanded at the two cancer centers.
Vaccine rates in patients on hemodialysis are substantially lower than the Healthy People 2020 targets. The purpose of this study is to utilize the perceptions and cues for action constructs of the Health Belief Model (HBM) to assess the attitudes of patients receiving outpatient hemodialysis regarding acceptance of the seasonal influenza, pneumococcal, and hepatitis B virus vaccines. Vaccine acceptance is defined as receiving the vaccine. Study findings suggest age, perceived susceptibility, and perceived severity increase the odds of getting some vaccines. Findings have implications for the development of patient education materials, interdisciplinary team assessments, and plan of care strategies to increase vaccine acceptance.
Abstract Background: The Healthy Immigrant Effect (HIE) phenomenon proposes that: (1) when immigrants arrive in the U.S., they are healthier than their locally born counterparts; and that (2) this health advantage dissipates over time. While this phenomenon has been well studied and documented among Asians and Hispanics, few studies have explored the HIE among blacks. Most research studies on prostate cancer (CaP) health disparities have focused on comparing Black men to other ethnic groups within the U.S. A research area that has been overlooked and understudied is the within-group differences among black men. We investigated the ethnic variations among native-born black men, African-born black men, and Caribbean-born black men on: (1) personal history of CaP; (2) discussion of CaP risk reduction and early detection with physician; (3) screening by digital rectal examination (DRE); (4) screening by prostate specific antigen (PSA); (5) CaP knowledge; (6) diet; (7) use of chemoprevention products; and (8) physical activity. Methods: This study was part of the Florida Prostate Cancer Disparity Project referred to as the PIPCaD project. The inclusion criteria were black men (regardless of country of origin) who were 35 years and older. Data collection took place primarily in five Florida counties. Using a previously validated survey, data were collected from over 3,400 black men. A one-way ANOVA analyses were carried out to determine if there were significant differences among the three groups on outcome variables. Results: Of the 3,410 responses received, 3,040 indicated their ethnicity: 2,405 were native-born black men, 315 were African-born black men, and 320 were Caribbean-born black men. We found significant differences on CaP knowledge level (F{2,3016} = 13.43, p<.001), vegetable consumption (F{2,3016} = 13.43, p<.001), use of chemoprevention products (F{2,3016} = 13.43, p < .001). Post hoc tests revealed that native-born men had significantly higher CaP knowledge compared to African-born and Caribbean-born men (p<.05). Chi-square test results comparing the three groups were significant for frequencies of meat consumption (χ2{2} = 45.2845, p <.001), discussion of CaP risk-reduction and early detection with a doctor (χ2{2} = 3.81, p =.022), and insurance status (χ2{2} = 8.5071, p <.014). Relative to diet, significantly more native-born men reported meat products make up the biggest portion of their meal. Over 70% of native-born men reported eating meat at least four to six times a week compared to 64% African-born men and 62% Caribbean-born men. Although African-born men were the least insured of the three groups, more men in this group reported that they discuss CaP risk-reduction and early detection with a physician every chance they get compared to native born and Caribbean-born men. In addition, the frequency of chemoprevention use was highest among African-born men. Discussion: Given the significant number of foreign-born blacks in the U.S., it is important to disaggregate the data of native-born and foreign-born blacks to identify knowledge gaps and develop effective programs and policies to address disparities. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):PR-2.
Since behavioral factors are significant determinants of population health, addressing prostate cancer (CaP)-related health beliefs and cultural beliefs are key weapons to fight this deadly disease. This study investigated the health beliefs and cultural beliefs of black men relative to CaP, and the key socio-demographic correlates of these beliefs. The study design was a cross-sectional survey of 2,864 Florida black men, age 40 to 70, on their perceived susceptibility, perceived severity, attitude, outcomes beliefs, perceived behavioral control, CaP fatalism, religiosity, temporal orientation, and acculturation relative to CaP screening and prevention. The men reported favorable attitude and positive outcome beliefs, but moderate perceived behavioral control, CaP susceptibility and CaP severity. They also had low level of acculturation, did not hold fatalistic beliefs about CaP, had high religious coping skills and had high future time perspective. Several demographic variables were found to be associated with health beliefs and cultural beliefs. Our study provides rich data with regard to the health and cultural beliefs that might serve to inform the development of CaP control initiative for US-born and foreign-born black men.
