A church-based program on prostate cancer screening for African American men: Reducing health disparities

Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.