From the Department of Family Medicine, Medical University of South Carolina, Charleston, SC (NS); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (KRS).
J Am Board Fam Med. 2021 Sep-Oct;34(5):925-936. doi: 10.3122/jabfm.2021.05.210149.
Black men are disproportionately impacted by prostate cancer (PrCa). Current guidelines recommend that all men make informed decisions about whether to be screened for PrCa. Little is known about the barriers and facilitators of informed decision-making (IDM) about PrCa screening in Black men.
We conducted focus groups with a convenience sample of Black men aged 55 to 69 years from a primary care practice (n = 21). Template analysis was used to evaluate themes related to barriers and facilitators of IDM about PrCa screening.
IDM was impacted by external factors, intrinsic factors, and personal beliefs about PrCa screening. Family, friends, and clinicians played a paramount role in shaping attitudes about PrCa screening. Distrust of the medical community impaired IDM, and lack of clinician communication about PrCa screening further engendered mistrust. Participants felt they lacked adequate knowledge to make an informed decision about PrCa screening. Identified areas to promote IDM included education on racial disparities, education that screening is a personal choice, and differentiating PrCa screening from colon cancer screening.
Our results indicate that Black men may lack the prerequisite information to make informed decisions about PrCa screening, which is notable in light of known PrCa racial disparities. Clinicians can play an important role in facilitating IDM through fostering discussions about the benefits and risks of PrCa screening and educating Black men about racial disparities.
黑人男性受前列腺癌（PrCa）的影响不成比例。目前的指南建议所有男性都能就是否接受 PrCa 筛查做出明智的决定。关于黑人男性进行 PrCa 筛查的知情决策（IDM）的障碍和促进因素知之甚少。
我们对来自初级保健实践的 55 至 69 岁的黑人男性进行了焦点小组（n=21）。使用模板分析来评估与 PrCa 筛查 IDM 的障碍和促进因素相关的主题。
IDM 受到外部因素、内在因素和个人对 PrCa 筛查的信念的影响。家庭、朋友和临床医生在塑造对 PrCa 筛查的态度方面发挥了至关重要的作用。对医疗保健机构的不信任会损害 IDM，而临床医生对 PrCa 筛查缺乏沟通则会进一步引发不信任。参与者认为他们缺乏足够的知识来做出有关 PrCa 筛查的明智决定。促进 IDM 的领域包括关于种族差异的教育、关于筛查是个人选择的教育，以及将 PrCa 筛查与结肠癌筛查区分开来。
我们的结果表明，黑人男性可能缺乏有关 PrCa 筛查的先决信息，这在已知的 PrCa 种族差异方面值得注意。临床医生可以通过促进关于 PrCa 筛查的益处和风险的讨论并教育黑人男性有关种族差异，在促进 IDM 方面发挥重要作用。
