Religious involvement and prostate cancer screening behaviors among southeastern African American men

Prostate Cancer and Spirituality: A Systematic Review

The diagnosis, treatment, and sequels of cancer are relevant sources of stress, conflicts, and suffering, but spirituality may be a positive coping element. However, studies involving the correlation between prostate cancer patients and spirituality are few and heterogeneous. MEDLINE (PUBMED), SCOPUS, and EMBASE were the databases used for this review with the keywords "spirituality," "religion," and "prostate cancer." The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. About 250 articles were found, and 30 were eligible. Most studies (N = 26; 86.6%) reported the relationship between spirituality and better health findings such as 80% being positively associated with more screening for prostate cancer and better patients' quality of life. More interventional, randomized, and multicentric trials are needed to clarify this relationship.

Faith as a Mechanism for Health Promotion among Rural African American Prostate Cancer Survivors: A Qualitative Examination

Conceptualized using critical race theory as a theoretical underpinning, this study analyzed the lived experiences of older, rural, African American male prostate cancer (hereafter referenced as PrCA) survivors' faith and health promotion practices within Northeast Louisiana. Qualitative data from journaling, observations, and semi-structured interviews were obtained from ten older, African American male PrCA survivors residing in four rural parishes of Louisiana. The data analysis employed a two-stage approach known as Polkinghorne's analysis of narratives and narrative analysis using an art-based methodological approach. Framed as composite character counterstories, survivors' narratives revealed how survivors made sense of and gave meaning to their PrCA diagnosis, treatment, recovery, and survivorship. Specifically, their counterstories indicate that centering and honoring the unique and often taken-for-granted perspectives of older, rural, African American male PrCA survivors offered a deeper understanding of the multiple factors influencing their quality of life, as well as the sociostructural mechanisms impacting their survivorship care. Faith was examined as both a secular and sacred source of support that these men viewed as central to the acceptance of their diagnosis, treatment, recovery, and survivorship.

Exploring Racial Differences Surrounding Prostate Cancer Screening: Beliefs and Attitudes in Community Dwelling Men Attending an Urban Men's Health Event

The purpose of the study was to explore attitudes/beliefs in men attending an urban health fair to explore barriers to prostate cancer (PCa) screening. Five hundred and forty-four men attending the PCa booth at the fair in 2014 or 2015 completed questionnaires about PCa. Data were examined using Pearson’s χ², Fisher’s Exact, and Wilcoxon rank tests after grouping men by African American (AA) and non-African American ethnicity. Three hundred and twenty-six (60%) men were AA and two hundred and eighteen (40%) were non-AA (89% white). Median age (54 vs. 56 years) and prior PCa screening were similar between AA and non-AA; income (p = .044) and education (p = .0002) differed. AA men were less likely to have researched prostate-specific antigen (PSA) on the internet (p = .003), but more used TV (p = .003) and media (p = .0014) as information sources. Family members had a stronger influence over screening decisions for AA men (p = .005). After reading PSA information, AA men were more likely to still be confused (p = .008). A higher proportion of AA men were less worried about dying from PCa (p = .0006), but would want treatment immediately instead of watchful waiting (p < .0001). Interestingly, a higher proportion of AA men indicated that they would prefer not to know if they had PCa (p = .001). Ultimately, more AA men had a PSA done (98.4% vs. 95.1%; p = .031). When considering screening eligible men, a higher proportion of AA men had an abnormal PSA (13.1% vs. 5.3%; p = .037). AA men’s beliefs surrounding PCa differ from non-AA men, and should be considered when developing culturally appropriate education, screening, and treatment strategies for this group.

A Spiritually-Based Text Messaging Program to Increase Cervical Cancer Awareness Among African American Women: Design and Development of the CervixCheck Pilot Study

Background

Although Hispanic women have the highest cervical cancer incidence rate, African American women account for a disproportionate burden of cervical cancer incidence and mortality when compared with non-Hispanic white women. Given that religion occupies an essential place in African American lives, delivering health messages through a popular communication delivery channel and framing them with important spiritual themes may allow for a more accessible and culturally appropriate approach to promoting cervical cancer educational content to African American women.

Objective

The aim of this paper was to describe the design and development of the CervixCheck project, a spiritually based short message service (SMS) text messaging pilot intervention to increase cervical cancer awareness and Papanicolaou test screening intention among church-attending African American women aged 21 to 65 years.

Methods

Through focus group interviews (n=15), formative research was conducted to explore facilitators, motivators, and barriers to cervical cancer screening. The interviews were also used to identify logistical factors that should be considered when developing the CervixCheck intervention. Culturally appropriate and spiritually grounded SMS text messages were developed based on the analysis of focus group data and the review of previous studies that incorporated technology into health behavior change interventions. After the CervixCheck intervention was developed, cognitive response interviews (n=8) were used to review the content of the SMS text messaging library, to ensure that the content was acceptable and understandable, particularly for church-attending African American women aged 21 to 65 years.

Results

Design and development of the SMS text messages involved consideration of the content of the messages and technological specifications. Focus group participants overwhelmingly reported cell phone use and an interest in receiving spiritually based SMS text messages on cervical cancer prevention and early detection. Findings from the cognitive response interviews revealed that the content of the SMS text messaging library was acceptable and understandable with the target population. The revised SMS text messaging library currently includes 22 messages for delivery over 16 days, averaging 11 texts per week, with no more than two messages delivered per day. Initial usability testing also showed early feasibility.

Conclusions

The design and development of the CervixCheck intervention provides important insight into what may be considered an overlooked minority population and missed opportunity in health information technology research. With increased internet penetration through the use of mobile phones, it is appropriate to investigate the viability of technology as a means to reach minority communities and to reduce health disparities.

Mixed Blessings? Religion/Spirituality Predicts Better and Worse Screening Behaviours

Some health research suggests that religious and spiritual variables positively predict health-screening behaviours. However, much of the literature on this topic has utilized exclusively religious samples, or has sampled from populations without uniform access to health care. Either of these issues may have artificially inflated the relationship between religion/spirituality and health-screening behaviours. The current study used data from the 2012 Canadian Community Health Survey to examine a general sample of women from New Brunswick and Manitoba (N > 1200). Results indicated that lower levels of church attendance were positive predictors of papanicolaou tests and mammograms, while higher levels of attendance were generally associated with poorer screening behaviours. Religiosity was a uniformly non-significant predictor of screening behaviours. Finally, religious affiliation was inconsistently related to screening behaviours, but tended to favour religious non-affiliation when it was. Religion/spirituality does not appear to have a uniformly positive nor linear effect in predicting health-screening behaviours in women.

Understanding Cervical Cancer Screening among Latinas through the Lens of Structure, Culture, Psychology and Communication

This study explored how structural and cultural forces work together with psychological and communication factors in influencing Pap test compliance among Latinas in Los Angeles County, a group who face health disparities related to cervical cancer screening, incidence and mortality. By adopting a multilevel approach to obtain a grounded understanding of this issue, this work revealed that structural barriers, fatalism, religious service attendance, perceived susceptibility, perceived costs, and cues to action from health care providers are all associated with Pap test compliance. Financial barriers also influence compliance, with underinsurance having a stronger negative impact compared to no insurance at all. These findings provide insights into how communication efforts can be strategically designed to address both individual- and system-level barriers to promote health-seeking behaviors among Latinas, and potentially among other population groups experiencing health disparities due to similar reasons.

Religious Coping and Types and Sources of Information Used in Making Prostate Cancer Treatment Decisions

Treatment experiences for prostate cancer survivors can be challenging and dependent on many clinical and psychosocial factors. One area that is less understood is the information needs and sources men utilize. Among these is the influence of religion as a valid typology and the value it may have on treatment decisions. The objective of this study was to assess the relationship between race, religion, and cancer treatment decisions in African American men compared with White men. Data were from the Diagnosis and Decisions in Prostate Cancer Treatment Outcomes Study that consisted of 877 African American and White men. The main dependent variables sought respondents' use of resources or advisors when making treatment decisions. Questions also assessed men perceptions of prostate cancer from the perspective of religious coping. After adjusting for age, marital status, education, and insurance status, race differences in the number of sources utilized were partially mediated by cancer was a punishment from God (β = -0.46, SE = 0.012, p < .001), cancer was a test of faith (β = -0.49, SE = 0.013, p < .001), and cancer can be cured with enough prayer (β = -0.47, SE = 0.013, p < .001). Similarly, race differences in the number of advisors utilized in making the treatment decision were partially mediated by cancer was a punishment from God (β = -0.39, SE = 0.014, p = .006), and cancer was a test of faith (β = -0.39, SE = 0.014, p = .006). Religious views on prostate cancer may play an important role in explaining race differences in information used and the number of advisors utilized for treatment decision making for prostate cancer.

Demographic, Social Support, and Community Differences in Predictors of African-American and White Men Receiving Prostate Cancer Screening in the United States

OBJECTIVE

To examine demographic, social support, and community factors from a national dataset that influence African-American (AA) and White men to receive prostate cancer screening (PCS) via the Digital Rectal Exam (DRE) or Prostate Specific Antigen Test (PSA).

DESIGN AND SAMPLE

A cross-sectional secondary analysis from the National Health and Nutrition Examination Survey (NHANES) provided the sample of AA (N = 377) and White (N = 971) men over the age of 40 years. Regression analysis with confidence intervals was utilized to examine the factors associated with AA and White men receiving PCS. The Social Ecological Model provided the theoretical framework.

MEASURES

Questionnaires from the NHANES dataset provided data for this study.

RESULTS

Age, education, and access to health care was associated with AA and White men receiving the DRE. Income and church attendance was only associated with White men receiving the DRE. Only White men had an association of income with receiving the PSA test and only AA men had an association of marital status with receiving the PSA test.

CONCLUSIONS

Cultural evaluations of PCS behaviors among AA men are necessary to decrease the health disparity of prostate cancer among the AA population.

How Organ Donors are Different from Non-donors: Responsibility, Barriers, and Religious Involvement

To see if religious involvement, previously linked to various health behaviors, was linked to organ donation, 143 ethnically diverse undergraduates stated whether they were registered donors (53% were), and completed measures of organ donation attitudes and religious involvement. Compared with non-donors, donors reported fewer barriers, more family responsibility, and more willingness to receive donor organs, but were not different in religious involvement. Even in 2014, when being a "good Samaritan" by agreeing to organ donation is as easy as checking one box on a driver's license application, religious involvement does not seem to be a factor in checking this box.

Religion, fatalism, and cancer control: a qualitative study among Hispanic Catholics

OBJECTIVES

To assess cancer perceptions among churchgoers and to examine the potential influence of fatalism and religious beliefs on the use of cancer screening tests.

METHODS

Eight semi-structured focus groups were conducted among 67 Hispanic Catholics in Massachusetts.

RESULTS

In this sample, there were few references to fatalistic beliefs about cancer and nearly universal endorsement of the utility of cancer screening for cancer early detection. Most participants reported that their religious beliefs encouraged them to use health services, including cancer-screening tests. Although participants agreed that God plays an active role in health, they also affirmed the importance of self-agency in determining cancer outcomes.

CONCLUSIONS

Our findings challenge the assumption that fatalism is an overriding perspective among Hispanics. Catholic religious beliefs may contribute to positive health attitudes and behaviors.

Dimensions of religiousness and cancer screening behaviors among church-going Latinas

Churches are a promising setting through which to reach Latinas with cancer control efforts. A better understanding of the dimensions of religiousness that impact health behaviors could inform efforts to tailor cancer control programs for this setting. The purpose of this study was to explore relationships between dimensions of religiousness with adherence to cancer screening recommendations among church-going Latinas. Female Spanish-speaking members, aged 18 and older from a Baptist church in Boston, Massachusetts (N = 78), were interviewed about cancer screening behaviors and dimensions of religiousness. We examined adherence to individual cancer screening tests (mammography, Pap test, and colonoscopy), as well as adherence to all screening tests for which participants were age-eligible. Dimensions of religiousness assessed included church participation, religious support, active and passive spiritual health locus of control, and positive and negative religious coping. Results showed that roughly half (46 %) of the sample had not received all of the cancer screening tests for which they were age-eligible. In multivariate analyses, positive religious coping was significantly associated with adherence to all age-appropriate screening (OR = 5.30, p < .01). Additional research is warranted to replicate these results in larger, more representative samples and to examine the extent to which enhancement of religious coping could increase the impact of cancer control interventions for Latinas.

Pre-screening age African-American males: what do they know about prostate cancer screening, knowledge, and risk perceptions?

Prostate cancer is the most commonly diagnosed cancer among men and the second most common cause of cancer mortality among men in America. African-American men have a mortality rate from prostate cancer twice that of Caucasian men. Although prostate screening remains controversial, it provides an opportunity for the cancer to be detected early when treatment is most effective. Limited research has been conducted regarding prostate cancer awareness and knowledge among African-American men under 50. This article highlights a pilot study assessing the knowledge, attitudes, risk perceptions, and reasons for participating in prostate cancer screening among African-American males between the ages of 30-45. Study findings suggest these participants recognized an awareness of risk factors associated with the disease, yet underestimated their risk of developing the disease. Additionally they present uneven knowledge of the prostate and its function and possess positive perceptions of their general health beliefs and practices. Practice implications and directions for future research regarding prostate cancer among this population are highlighted.

It takes two to talk about prostate cancer: a qualitative assessment of African American men's and women's cancer communication practices and recommendations

Prostate cancer (PrCA) is the most commonly diagnosed nonskin cancer among men. African American (AA) men in South Carolina have a PrCA death rate 150% higher than that of European American (EA) men. This in-depth qualitative research explored AA men's and women's current practices, barriers, and recommended strategies for PrCA communication. A purposive sample of 43 AA men and 38 AA spouses/female relatives participated in focus groups (11 male groups; 11 female groups). A 19-item discussion guide was developed. Coding and analyses were driven by the data; recurrent themes within and across groups were examined. Findings revealed AA men and women agreed on key barriers to discussing PrCA; however, they had differing perspectives on which of these were most important. Findings indicate that including AA women in PrCA research and education is needed to address barriers preventing AA men from effectively communicating about PrCA risk and screening with family and health care providers.

Religious involvement measurement model in a national sample of African Americans

This study examined the factor structure of a brief measure of religious involvement developed previously in research with African American women. Telephone interview methods were used with a national sample of both African American women and men (N = 2,370). Confirmatory factor analyses supported the distinction between religious beliefs and religious behaviors factors and indicated that the factor loadings were equivalent for women and men. Women reported higher levels of religious involvement than men. These results support the validity of this relatively brief instrument for assessing these two dimensions of religious involvement for both African American women and men.