Abbott R R, Taylor D K, Barber K
Cancer Center, Hurley Medical Center, Flint, Michigan, USA.
Cancer J Sci Am. 1998 May-Jun;4(3):175-7.
This study was undertaken to determine if a community screening program designed to overcome key barriers (lack of awareness, cost of program, ease of access to care) could successfully impact on African-American males' knowledge, attitudes, and behaviors regarding prostate cancer screening. The focus of this report is knowledge. To date, there are no reported studies that examine differences in knowledge from a prescreening baseline to a postintervention level for minority participants.
A total of 944 men were enrolled in the study in a 20-month period. Prostate screening and education were offered as a new service at an existing senior health clinic. In addition, mass screenings were offered approximately monthly at various locations in the community (including senior community centers, senior apartment complexes, and some public housing projects). Screening included both the digital rectal examination and the prostate specific antigen test. A brief questionnaire was administered during client intake (the pretest) and repeated after the education and screening participation (the posttest). Test items targeted three constructs: (1) etiology, (2) risk status, and (3) clinical factors.
The largest difference on pretest scores between the racial groups resulted from clinical factor knowledge. African-American men were significantly less likely than Caucasian men to correctly identify early symptoms of prostate cancer and the basic components of a prostate checkup. Although scores were initially significantly lower for African-American participants, these differences were not evident after program involvement. There was a significant increase in knowledge level for all men when comparing pretest and posttest scores. Significant improvement was noted for each test item, with the exception of one key item. Even after participation in the program, African-American men were still more likely to believe that "pain" was the first symptom of prostate cancer.
An item-by-item analysis revealed that there was only one test item in which program participation did not "correct" knowledge. African-American men were still more likely to believe that pain was the first symptom that would alert them to the presence of cancer. The screening program included information (both printed and oral content) that emphasized the importance of routine screening to detect cancer at an early stage, because most men would experience no symptoms. The only other reported study that examined knowledge documented similar findings with respect to an understanding of symptomology. These findings can be used to direct or guide the educational component of future screening programs that hope to target African-American men.
本研究旨在确定一项旨在克服关键障碍（缺乏认识、项目成本、获得医疗服务的便利性）的社区筛查项目是否能成功影响非裔美国男性在前列腺癌筛查方面的知识、态度和行为。本报告的重点是知识。迄今为止，尚无研究报告探讨少数族裔参与者从筛查前基线到干预后水平的知识差异。
在20个月的时间里，共有944名男性参与了该研究。前列腺筛查和教育作为一项新服务在现有的老年健康诊所提供。此外，大约每月在社区的不同地点（包括老年社区中心、老年公寓小区和一些公共住房项目）进行大规模筛查。筛查包括直肠指检和前列腺特异性抗原检测。在客户登记时（预测试）发放一份简短问卷，并在参与教育和筛查后（后测试）再次发放。测试项目针对三个方面：（1）病因，（2）风险状况，（3）临床因素。
不同种族群体在预测试分数上的最大差异源于临床因素知识。与白人男性相比，非裔美国男性正确识别前列腺癌早期症状和前列腺检查基本组成部分的可能性显著更低。尽管非裔美国参与者的分数最初显著较低，但在参与项目后这些差异并不明显。比较预测试和后测试分数时，所有男性的知识水平都有显著提高。除了一个关键项目外，每个测试项目都有显著改善。即使参与了该项目，非裔美国男性仍然更有可能认为“疼痛”是前列腺癌的首要症状。
逐项分析显示，只有一个测试项目中项目参与并未“纠正”知识。非裔美国男性仍然更有可能认为疼痛是提醒他们患癌的首要症状。筛查项目包括强调早期进行常规筛查以检测癌症重要性的信息（包括印刷内容和口头内容），因为大多数男性不会出现症状。唯一另一项研究知识情况的报告在症状理解方面记录了类似的发现。这些发现可用于指导未来希望针对非裔美国男性的筛查项目的教育部分。
