Ukoli Flora A, Patel Kushal, Hargreaves Margaret, Beard Katina, Moton Pierre J, Bragg Richard, Beech Derrick, Davis Rodney
Department of Surgery, Meharry Medical College, Nashville, TN 37208, USA.
J Health Care Poor Underserved. 2013 Feb;24(1):311-31. doi: 10.1353/hpu.2013.0033.
African American men bear disproportionate burden of prostate cancer (PCa) that can be reduced by early detection. A 15-minute culturally appropriate PCa education intervention developed to communicate effective, relevant, and balanced PCa screening information to low-income African American men was evaluated in men 42 years and older who had not been screened in one year. Of 539 men enrolled, 392 (72.7%) completed the six-month follow-up. Mean age was 54.4±8.9, 34.7% had no high school diploma, and 65.3% earned less than $25,000 annually. Barriers to screening included health insurance (41.4%), discomfort of digital rectal exam (32.1%), and fear of cancer diagnosis (29.9%). Mean knowledge score of 21 points increased from 13.27±3.51 to 14.95±4.14 (p<.001), and prostate-specific antigen screening from 22.1% to 62.8%. Men without high school diploma recorded the lowest post-intervention PCa knowledge and screening rate (47.7%), suggestive of the need for more than a single education session. Annual physicals with free prostate examination can maintain the positive trend observed.
非裔美国男性承受着不成比例的前列腺癌负担,而早期检测可减轻这一负担。我们评估了一项针对低收入非裔美国男性开展的15分钟的前列腺癌教育干预措施,该措施在文化上具有针对性,旨在传递有效、相关且平衡的前列腺癌筛查信息,参与评估的是42岁及以上且一年内未接受筛查的男性。在539名登记参与的男性中,392名(72.7%)完成了为期六个月的随访。平均年龄为54.4±8.9岁,34.7%的人没有高中文凭,65.3%的人年收入低于25,000美元。筛查的障碍包括医疗保险(41.4%)、直肠指检不适(32.1%)以及对癌症诊断的恐惧(29.9%)。平均知识得分从13.27±3.51分提高到了14.95±4.14分(p<.001),前列腺特异性抗原筛查率从22.1%提高到了62.8%。没有高中文凭的男性在干预后的前列腺癌知识和筛查率最低(47.7%),这表明需要不止一次教育课程。提供免费前列腺检查的年度体检可以维持观察到的积极趋势。