Husaini Baqar A, Reece Michelle C, Emerson Janice S, Scales Samuel, Hull Pamela C, Levine Robert S
Center for Health Research, Tennessee State University, 3500 John Merritt Blvd, PO Box 9580, Nashville, TN 37209-1561, USA.
Ethn Dis. 2008 Spring;18(2 Suppl 2):S2-179-84.
African American men have a significantly higher incidence of prostate cancer, are diagnosed at younger ages and more advanced stages, and have higher mortality rates from prostate cancer than do White men.
This community-based intervention study employed a quasiexperimental delayed-control (crossover) design with randomization at the church level. Forty-five African American churches were randomly assigned to two study groups: early intervention and delayed intervention. A convenience sample of 430 African American male volunteers (ages 40-70) was enrolled through the churches, and 350 men remained in the study through wave 3. The intervention was a culturally tailored group educational program, which included a video and a question-and-answer session with an African American physician.
Within each group, knowledge, perceived threat, and screening prevalence all increased significantly. However, the magnitude of increases was similar, so the groups did not differ significantly at wave 2. Knowledge at wave 2 was associated with greater odds of having a digital rectal exam by wave 3 only for the early-intervention group. The early-intervention group was two times more likely to have talked to a physician about prostate cancer screening by wave 3.
The findings suggest that the delayed-intervention group did not function as a pure control and may have unintentionally received a partial intervention. This finding demonstrated that a low-cost prostate cancer awareness campaign within a church may be enough to affect prostate cancer knowledge, attitudes, and behaviors among African American men. Further research should examine the church-specific intervention elements, cultural appropriateness of the messages, and whether group sessions provide additional effect.
非裔美国男性前列腺癌的发病率显著高于白人男性，他们被诊断出患有前列腺癌的年龄更小、疾病分期更晚，且前列腺癌死亡率更高。
这项基于社区的干预研究采用了准实验性延迟对照（交叉）设计，并在教会层面进行随机分组。45个非裔美国教会被随机分为两个研究组：早期干预组和延迟干预组。通过教会招募了430名非裔美国男性志愿者（年龄在40 - 70岁之间）作为便利样本，到第三轮时仍有350名男性留在研究中。干预措施是一个根据文化定制的团体教育项目，包括一段视频以及与一位非裔美国医生的问答环节。
在每个组内，知识、感知到的威胁以及筛查普及率均显著提高。然而，提高的幅度相似，所以在第二轮时两组之间没有显著差异。仅在早期干预组中，第二轮的知识水平与到第三轮时进行直肠指检的更高几率相关。到第三轮时，早期干预组与医生谈论前列腺癌筛查的可能性是另一组的两倍。
研究结果表明，延迟干预组并未起到纯粹对照组的作用，可能无意中接受了部分干预。这一发现表明，在教会内开展的低成本前列腺癌宣传活动可能足以影响非裔美国男性对前列腺癌的知识、态度和行为。进一步的研究应考察教会特定的干预要素、信息的文化适宜性，以及团体课程是否能带来额外效果。
