Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
Department of Health Professions, University of Central Florida, Orlando, Florida.
Am J Prev Med. 2018 Nov;55(5 Suppl 1):S103-S111. doi: 10.1016/j.amepre.2018.05.028.
Black men are diagnosed with prostate cancer at nearly twice the rate of white men and are underrepresented in prostate cancer research, including validation studies of new clinical tools (e.g., genomic testing). Because healthcare system mistrust has contributed to these disparities for centuries, black men may be less inclined to pursue novel testing, and identification of facilitators to their participation in prostate cancer research studies remains warranted.
A community-engaged approach involving a partnership with a community organization was used to conduct seven focus groups in Minnesota, Alabama, and California to explore black men's attitudes toward prostate cancer research participation and genomic testing for prostate cancer. Data were collected and analyzed from April 2015 to April 2017.
Identified genomic testing barriers included a lack of terminology understanding, healthcare system mistrust, reluctance to seek medical care, and unfavorable attitudes toward research. Facilitators included family history, value of prevention, and the desire for health education. Lack of prostate cancer knowledge, prostate-specific antigen testing confusion, healthcare system distrust, and misuse of personal health information were barriers to research study participation. Some black men were motivated to participate in research if it was seen as constructive and transparent.
Disparities for black men can both motivate and disincentivize participation depending upon a positive or negative view of research. Confusion over prostate cancer clinical care has fueled some mistrust among black men affecting both clinical care and research participation. With increased education, health literacy, and assurances of research integrity and transparency, black men may be more willing to participate in prostate cancer testing and research.
This article is part of a supplement entitled African American Men's Health: Research, Practice, and Policy Implications, which is sponsored by the National Institutes of Health.
黑人男性被诊断出患有前列腺癌的几率几乎是白人男性的两倍，而且在前列腺癌研究中代表性不足，包括新的临床工具（如基因组检测）的验证研究。由于医疗保健系统的不信任导致了这些差异已经存在了几个世纪，黑人男性可能不太愿意接受新的检测，因此仍然需要确定促进他们参与前列腺癌研究的因素。
采用社区参与的方法，与社区组织合作，在明尼苏达州、阿拉巴马州和加利福尼亚州进行了七次焦点小组讨论，探讨黑人男性对参与前列腺癌研究和前列腺癌基因组检测的态度。数据收集和分析时间为 2015 年 4 月至 2017 年 4 月。
确定的基因组检测障碍包括缺乏术语理解、对医疗保健系统的不信任、不愿寻求医疗保健以及对研究的不利态度。促进因素包括家族史、预防的价值以及对健康教育的渴望。缺乏前列腺癌知识、前列腺特异性抗原检测混淆、对医疗保健系统的不信任以及个人健康信息的滥用是参与研究的障碍。如果研究被视为建设性和透明的，一些黑人男性有参与研究的动机。
对黑人男性的差异既可以激励也可以抑制他们的参与，这取决于他们对研究的积极或消极看法。对前列腺癌临床护理的混淆导致一些黑人男性对医疗保健系统产生了不信任，这影响了临床护理和研究参与。通过增加教育、健康素养以及对研究完整性和透明度的保证，黑人男性可能更愿意参与前列腺癌检测和研究。
本文是一篇名为《非裔美国男性健康：研究、实践和政策影响》的补充文章的一部分，该补充文章由美国国立卫生研究院赞助。
