DESCRIPTION (provided by applicant): Prostate cancer statistics reveal the most glaring example of racial/ethnically-based cancer health disparities among American males. African American men have the highest reported rate of prostate cancer in the world, with an incidence rate that is 1.4 times higher than that of whites, and a mortality rate that is 2.3 times greater. Given the range of possible treatments, their uncertain efficacies, their possible negative effects on quality-of-life, and the lack of clear-cut medical guidelines, decisions surrounding a prostate cancer diagnosis can be particularly confusing and anxiety-producing. The goal of this pilot project is to understand current knowledge, beliefs, and practices that either facilitate or inhibit pathways to receiving work-up and treatment for prostate cancer in the African American community. Results from this project will provide the basis for development of a decision aid to promote active participation of African American men and their families in prostate cancer diagnosis and treatment decisions while planning for overcoming barriers that may hinder these decisions. The many medical, social, and economic obstacles that families face in the decision maze will be explored. To accomplish these objectives, researchers will work in partnership with community partners, healthcare providers and government to build a community network to aid individuals in this decision process. Community partners have a long and successful collaboration through the Witness Project of LI, a faith based breast cancer outreach effort began in Arkansas. The impetus for this proposal stems from community requests to expand efforts to prostate cancer. Key informant interviews, focus groups and town meetings will be used to collect and synthesize information about what our community is "saying, doing and thinking" about an elevated Prostate Specific Antigen (PSA), work-up and treatment for prostate cancer. The specific aims of this pilot project are to: 1-determines patient-, community-, and system-level variables that facilitate or obstruct pathways to work-up and treatment for prostate cancer among African Americans; 2- collaborate with community partners to develop a prostate cancer treatment decision-aid based on interviews, focus groups, and town meetings. This project has the potential to foster community dialogue and create a decision aid for a disease that has tremendous medical, social and societal impact for African Americans. Greater patient involvement in decision making is also believed to improve health care quality.
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