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Purpose: The purpose of this study was to examine if prostate cancer (PCa) survivor confidence in communicating with their physician impacts planning to look for health information related to their treatment. Secondarily, we explored if this relationship differs by race. Experimental Procedures: Descriptive and multivariate analyses (Pearson Chi-Square) were conducted using SPSS 28. Perceived Efficacy in Patient-Physician Interactions (PEPPI-10) scale scores were summed, then a score of 30 was established as the cut point for high and low efficacy to ensure adequate data in all cells due to a small sample size. A survivor's plan to look was collected dichotomously as “plan to look for this information” and “not planning to look for this information”. For the crosstabulation, confidence was placed in the rows, plan to look in the columns, and race as layer 1. Summary of Data: 63 men who were treated for or actively monitoring localized PCa were purposefully sampled and completed a 119-item self-administered questionnaire (mean age = 64.17 years, white = 58.7%, African American = 41.3%, private health insurance = 51.6%, married/partnered = 79.4%). Twenty questions inquired about the survivors’ plan to look for treatment information. Confidence in ability to communicate with their physician was measured using the PEPPI-10 scale. Conclusions: Out of the 20 plan to look for treatment information questions, only “plan to look for treatment options insurance would cover” was significant (p= .018) in non-Hispanic White men. The findings suggest that men's level of confidence in their ability to talk with their provider does not influence their plan to look for treatment related information. Health seeking behaviors could be contributed to by other variables such as social support and the role survivors prefer to take in their care. Descriptively, our analysis showed more men plan to look up treatment related information regardless of level of confidence. Therefore, health care providers (HCPs) should not rely on a patients’ confidence to communicate, rather HCPs should plan to educate all patients on how to search for quality health information. To support patient-physician communication, resources such as prompt lists or patient navigators could be provided to patients to increase their ability to communicate with their physicians. Citation Format: Jala Lockhart, Levi Ross, James Leeper, Jordan Young. Does confidence in one’s ability to communicate with the physician impact health information seeking behavior? [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B013.

Background: Most men with prostate cancer lack sufficient knowledge of their illness at the time they are diagnosed to make informed decisions about treatment. The ways patients interact with physicians can influence the quality of treatment-related information that is received and impact emotional well-being. Regret is a common negative affect that patients, providers, and care givers seek to avoid. This study investigated the relationship between patient communication efficacy, treatment information seeking behaviors, and decision regret within a sample of early-stage prostate cancer survivors. Methods: Sixty-three men diagnosed with early-stage prostate cancer (Stage T1 or T2) completed self-administered questionnaires. Men who were actively monitoring or undergoing definitive treatment were eligible for inclusion. The 67-item data collection tool captured patient demographics, cancer treatment information seeking behaviors, and psychosocial characteristics. Communication efficacy was measured using the validated Perceived Efficacy Patient Physicians Interaction (PEPPI-10, α=.94) scale. Decision regret was assessed using a validated 5-item measure (Brehaut et al., 2003). Descriptive and comparative analyses were conducted using SPSS Version 25. Results: A majority of participants were White (58.7%), married/partnered (79.4%), privately insured (54.2%) and graduated college (75.0%). More than two-thirds (77.8%) wanted to assume an active role during treatment decision-making. Most respondents (58.1%) fell within the high efficacy communication group (+/- 1/2 s.d. of the mean). A majority of men did not regret their initial treatment choice (82.5%). Men who regretted their initial treatment choice reported significantly more unmet treatment information needs (Mean= 5.63) than those who did not regret (Mean= 2.78) their treatment decision [t(60) = 2.084, p = .041]. Independent samples t-test results showed a statistically significant relationship between regret and communication efficacy [t(60) = -2.38, p =.021]. The two situations where men who regretted their decisions reported lower levels of communication efficacy were getting doctors to pay attention to what they have to say [t(60) = -3.39, p = .001] and making the most of their visit with the doctor [t(60) = -2.22, p = .030]. Perceived communication efficacy marginally differentiated men who regretted and did not regret their treatment decisions in two more clinical situations [t(60) = -1.92, p = .060; t(60) = -1.97, p = .054]. Conclusion: Communication efficacy appears to impact patient treatment information seeking behaviors and decision regret. Communication interventions need to be developed to increase early stage prostate cancer patients’ level of confidence when seeking treatment information to enhance their emotional well-being and quality of life. Citation Format: Levi Ross, Jordan S. Young, Jala Lockhart, Torhonda Lee, Ashley Bowers, Guleer Shabab, Michael A. Preston. Patient communication efficacy, information seeking, and treatment regret among early-stage prostate cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3220.

To test the efficacy of a community-based intervention, Empowering Communities for Life (EC4L), designed to increase colorectal cancer (CRC) screening through fecal occult blood test (FOBT) in rural underserved communities in a randomized controlled trial. Participants were randomized into 3 groups (2 interventions and 1 control). Interventions were delivered by community lay health workers or by academic health professionals. The main outcome of interest was return rate of FOBT screening kit within 60 days. Participants included 330 screening-eligible adults. The overall return rate of FOBT kits within 60 days was 32%. The professional group (Arm 2) had the highest proportion of returned FOBTs within 60 days at 42% (n = 46/110), a significantly higher return rate than the lay group (Arm 1) [28%(n = 29/103);P = 0.0422] or control group (Arm 3) [25%(n = 29/117);P = 0.0099]. Thus, one arm (Arm 2) of our intervention produced significantly higher CRC screening through FOBT. Community-based participation partnered with academic health professionals enhanced CRC screening among rural and poor-resourced communities.

“…intensive, community-based, culturally sensitive educational programs incorporating the spiritual environment of the faith community can positively influence screening behaviors in rural, underserved groups of African American women” Deborah O. Erwin, 1999 The Witness Project is a culturally competent, community-based outreach navigation program founded in Arkansas (AR) where access to mammography screening was especially problematic in certain areas. The (now) National Witness Project® (NWP) has been widely disseminated across the country. Women identify NWP as trusted and familiar providers of breast and cervical cancer education and invaluable assistance. Objective: Examine the NWP-AR chapter's evolution and past 10 years' experiences navigating rural women. Methods: NWP-AR provides African-American (AA) and all medically underserved women in rural communities with education and outreach navigation services to mammography as needed. They facilitate implementations of modular or mobile units in areas without facilities (service deserts). In 2007 NWP-AR was implemented in 34 counties and 9 in 2017. Results: In 2007 there were 1,374 women enrolled in NWP-AR, 84.6% of whom were rural folk. New enrollees (n=1,305) between March 2002-July 2007 were 54.9+/-11.5 years old and mostly AA, Caucasian, or Hispanic (75.7%, 22.1%, 1.7%), married or single (39.9%, 38.2%), and uninsured (82.1%). Medicare or Medicaid use was 31.7%. Initial service location choices were mobile, modular, and freestanding (54.9%, 25.9%, 14.6%). Over time rural women without facilities in their county (n=382) used modular or mobile (62.3%, 30.9%), rural women with facilities in their county (n=725) used mobile or modular (81.5%, 8.7%), and urban women (n=175) used freestanding or modular (61.1%, 19.4%). 2004 AR and national screening rates were 51.0% and 58.3%. In fiscal 2017, NWP-AR held 23 education/outreach events in 9 counties at mostly religious or residential centers (34.8%, 23.9%) and formed 10 new community partnerships in 8 counties. New enrollees (n=446) were ≥40 years of age (78.9%), AA or Caucasian (92.6%, 7.2%, 0.2%), and insured (92.6%). They made 488 contacts with enrollees. Modular units were phased out in favor of mobile units. In the 10 screening events in 8 counties, 138 AA or Caucasian (81.9%, 18.1%) women 40-49 (20.3%), 50-64 (40.6%), and ≥65 (39.1%) years of age were screened. All were insured. Navigation services to screening and later diagnostic testing were used by 67.4% and 2.9%. 2016 AR and national screening rates were 67.8% and 72.4%. Conclusion: In the 1990s NWP-AR pioneered activations of mobile mammography to rural and underserved areas. They have maintained their positive influences on the screening behavior of AA women. Despite a more focused implementation (34 vs. 9 counties), new enrollment rates almost doubled (~241 in 2007 to 446 in 2017), likely due to the feasibility of the mobile bus units. More work is needed as AR rates remain below average. Citation Format: Julia Devonish, Deborah O. Erwin, Detric Johnson, Frances Harfouche, Levi Ross, Cynthia Maxwell. Community outreach navigation of minority and medically underserved women in rural Arkansas to mammography facilities: Evolution and experiential results of the National Witness Project® from the last decade [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A018.

There is a paucity of studies examining the beneficial effects of fish consumption on cardiovascular diseases (CVDs) among adults with diabetes, who experience a substantially high risk of CVDs.We analyzed the data of 1136 adults with diabetes mellitus aged 18 years and older who participated in the National Health and Nutrition Examination Survey, 1988-1994, and were followed up through December 31, 2010. We used Cox regression to estimate the adjusted hazard ratios (HRs) for the relative risk across the levels of fish consumption. A total of 698 deaths were recorded at the end of 11,465 person-years follow-up with a mortality rate of 60.88 per 1000 person-years. CVDs were listed as a contributing cause for 326 deaths, thus accounting for 46.4% of total deaths. Stroke-specific mortality rate among patients who ate fish less than once a week was more than twice as high as that among patients who ate fish more than twice a week, 6.23 vs. 2.36 per 1000 person-years, respectively. The corresponding CVD-specific rate was 34.38 vs. 22.99 per 1000 person-years, respectively. The adjusted HRs of death due to stroke were 1.00 (reference), 0.55 (95% confidence interval = 0.28-1.07), and 0.30 (0.11-0.80) among patients who ate fish1, 1-2, and 2 + times a week, and the corresponding HRs of death due to CVDs were 1.00 (reference), 0.78 (0.60-1.02), and 0.69 (0.50-0.96), respectively.A high consumption of fish was associated with a low risk of death due to CVDs, especially stroke, among adults with diabetes.

There is a consensus about the benefits of community-based participatory research and the important role it can play in reducing cancer health disparities. Although every community-based participatory research project is unique in many ways, several fundamental issues deserve consideration. We discuss issues concerning community representation, possible tensions within community-based participatory research (CBPR) projects, and staffing CBPR projects. Flexibility, open-mindedness, transparency, and above all, caring, are characteristics that best ensure successful and rewarding outcomes.

Community-based participatory research (CBPR) is becoming one of the dominant approaches for bringing evidence- and consensus-based cancer prevention and control practices to medically underserved communities. There are many examples of how CBPR has been useful for generating culturally specific solutions for different health issues that affect African-Americans. However, few examples exist in the literature on how the CBPR approach can be applied to address prostate cancer. This paper describes a collaborative process for linking inner-city, African-American men to free prostate cancer education, physician counseling, and screening opportunities (prostate-specific antigen (PSA) testing and digital rectal examination (DRE)). The site of this community-based participatory project was the city of Buffalo, located in Erie County, New York. The collaborative, community-academic process that is described includes the following: (1) planning and conducting a community needs assessment to contextualize local prostate cancer issues, (2) organizing town and gown event planning, and (3) manipulating aspects of the built environment to build an infrastructure within the community to address disparities in screening opportunities. This paper concludes with a description of lessons learned that can help others develop and implement similar activities in other communities.

There have been very few studies to rigorously evaluate the potential of African American barbers to educate men about prostate cancer in the barbershop setting. This research brief presents baseline data from a cross-sectional survey identifying differences in decisional conflict and stage of decision making by screening status from an efficacy trial to educate African American men about informed decision making for prostate cancer screening. Those men who had already received the prostate-specific antigen (PSA) test were more advanced in their stage of decision making and had less decisional conflict about the PSA test than those men who had never received a PSA test. Educational interventions to increase informed decision making with prostate cancer screening must consider previous PSA test history as a mediating variable affecting decision self-efficacy.

A challenge for health behavior science is to develop theory and best practices that take cultural diversity into account. Using data from Black, Hispanic, and White respondents to the 2003 Health Information National Trends Survey, we examined racial/ethnic differences in: (1) breast cancer risk perceptions/worry; (2) the associations between perceived risk/worry and ever having received a mammogram; and (3) perceived risk/worry and having had at least 2 mammograms over a 4-year period (consecutive mammography). Compared to White race/ethnicity, Black race/ethnicity was associated with lower perceived absolute risk and comparative risk for developing cancer. For the sample as a whole, higher perceived risk (both absolute risk and comparative risk) and worry predicted greater odds of mammography use; however, this was not true for Hispanics. In stratified analyses, perceived risk and worry were not associated with mammography use for either Hispanics or Blacks whereas they were for Whites; however, this interaction effect was significant only for Hispanics vs. Whites. Results support the need for formative research to identify determinants of health behavior prior to cancer prevention message planning for diverse audiences in order to accommodate racial/ethnic differences not only in the level of perceived risk, but also the association between risk perception to behavior change in that community.

A major challenge facing contemporary cancer educators is how to optimize the dissemination of breast cancer prevention and control information to African American women in the Deep South who are believed to be cancer free. The purpose of this research was to provide insight into the breast cancer information-acquisition experiences of African American women in Alabama and Mississippi and to make recommendations on ways to better reach members of this high-risk, underserved population.Focus group methodology was used in a repeated, cross-sectional research design with 64 African American women, 35 years old or older who lived in one of four urban or rural counties in Alabama and Mississippi.Axial-coded themes emerged around sources of cancer information, patterns of information acquisition, characteristics of preferred sources, and characteristics of least-preferred sources.It is important to invest in lay health educators to optimize the dissemination of breast cancer information to African American women who are believed to be cancer free in the Deep South.

The purposes of this study are to explore cancer information acquisition patterns among African-American men and to evaluate relationships between information acquisition patterns and prostate cancer prevention and control knowledge. A random sample of 268 men participated in a statewide interviewer-administered, telephone survey. Men classified as non-seekers, non-medical source seekers, and medical source seekers of prostate cancer information differed on household income, level of education, and beliefs about personal risk for developing prostate cancer. Results from multiple regression analysis indicated that age, education, and information-seeking status were associated with overall levels of prostate cancer knowledge. Results from logistic regression analyses indicated that men who included physicians as one of many information resources (medical source seekers) had superior knowledge over non-seekers and non-medical source seekers on 33% of individual knowledge details. The findings emphasize the need to connect lower-income and lower-educated African-American men to physicians as a source of prostate cancer control information.

Background: We explored racial/ethnic differences in perceived cancer risk and determinants of these differences in a nationally representative sample of whites, blacks, Hispanics, and Asians. Methods: Multiple regression techniques, including mediational analyses, were used to identify determinants and quantify racial/ethnic differences in the perception of the risk of developing cancer among 5,581 adult respondents to the 2007 Health Information Trends Survey (HINTS). Results: Blacks, Hispanics, and Asians reported lower perceived cancer risk than whites [Bs = −0.40, −0.34, and −0.69, respectively; (Ps < 0.001)]. Contributing factors included relatively lower likelihood of reporting a family history of cancer, lower likelihood of having smoked, and a less strong belief that everything causes cancer among nonwhites than among whites. Racial/ethnic differences in perceived risk were attenuated in older respondents because perceived cancer risk was negatively associated with age for whites but not for nonwhites. Conclusions: Nonwhites had lower perceptions of cancer risk than whites. Some of the racial/ethnic variability in perceived risk may be due to racial and ethnic differences in awareness of one's family history of cancer and its relevance for cancer risk, experiences with behavioral risk factors, and salience of cancer risk information. Cancer Epidemiol Biomarkers Prev; 19(3); 746–54

Longitudinal studies have been conducted to evaluate correlates of stage of change movement among adult smokers but no studies were found to be conducted among adolescent smokers. This study used longitudinal data to examine adolescents' abstinence self-efficacy over 10-week and six-month periods and determined whether stage transitions were associated with concomitant changes or baseline values in perceived abstinence self-efficacy, nicotine dependence and motivation to quit. From baseline to 10-weeks results showed a change in motivation to quit and baseline stage were significantly associated with stage progression and regression. Additionally, intervention school status was significantly associated with stage progression. On the other hand, baseline score for nicotine dependence predicted stage regression not progression. Adolescents' becoming more or less 'ready' to quit smoking are influenced by their nicotine dependence and motivation to quit.

Cocaine use, marijuana use, alcohol use, and polysubstance use (e.g., alcohol and cocaine, alcohol and marifuana) are associated with high-risk sexual behavior and higher rates of sexually transmitted diseases (STDs) and human immunodeficiency virus (HIV). The purpose of this study was to examine readiness for using condoms among three groups (cocaine users, noncocaine drug users, and non-drug users) of African Americans living in low-income urban settings. African Americans in this sample differed in sex risk behaviors according to their drug use status. Noncocaine drug users reported higher levels of sex risk behaviors than non-drug users, and cocaine users reported the highest levels of risk. Cocaine users also reported lower levels of condom use with their main and nonmain sexual partners than both other groups. Results of multivariate analyses indicate that, compared to the other two groups, cocaine users are at earlier stages of readiness for condom use with main partners. Cocaine users have accurate perceptions of their HIV risk, but are more likely to factor into their decisions for using condoms cost and the trouble that it takes to get condoms. Different approaches to sexually transmitted disease and human immunodeficiency virus prevention will be necessary to meet the needs of these three different subgroups.

Background: Prostate cancer is the most commonly diagnosed cancer among men living in the United States. All men diagnosed with prostate cancer must undergo the complex process of treatment decision-making. Men have to be exposed to a range of issues related to treatment care planning and aftercare before they can make an informed treatment choice. The literature suggests that many men make prostate cancer treatment decisions before having all of their information needs satisfied. Patients who do not satisfy all of their information needs before undergoing treatment will have unmet needs. Men with unmet needs are more susceptible to making ill-informed choices and selecting treatment options that are poorly aligned with their preferences. Objectives: To quantify levels of unmet treatment information needs and to explore sociodemographic correlates of unmet needs among a sample of localized prostate cancer survivors. Methodology: From 2013 to 2014, sixty-three prostate cancer survivors completed self-administered surveys on a touch-screen computer. All participants were 40 years or older, self-identified as African American or White, was treated for or actively monitoring localized prostate cancer (Stage T1 or T2), and lived or worked in Western New York or Georgia. The survey collected information on sociodemographic variables, information seeking behavior, and treatment information needs. Unmet treatment information needs were classified as details or issues that survivors deemed important to know but did not explore before making their treatment decision. Each of the 20 treatment information need items was rated as “0 = unimportant” or “1= important”. An unmet needs composite scale was created which ranged from 0 - 20 (α = 0.895). Univariate statistics (frequencies, means and standard deviations) were computed to describe the study sample. Bivariate (T-test, ANOVA and Chi-square) and multivariate statistics were computed to examine associations between study variables. Significance levels for all statistical procedures was set at p ≤ 0.05. Results: Most participants were White (58.7%), college graduates (54.0%), not working (58.7%), married (78.4%) and had annual household incomes of $45,000+ (49.2%). A majority of participants (57.0%) reported at least one unmet information need (range = 0 – 19 unmet needs, mean = 2.83). African Americans reported more unmet needs than Whites (3.64African American vs. 2.50Whites). Results from multiple linear regression analysis indicated that race (β = -2.14, p = 0.05), income (β = -4.60, p = 0.01), and insurance status (β = 6.73, p = 0.01) were significant predictors of unmet information need (F(9,41) = 2.34; p = 0.03). African Americans were less likely to get information they wanted about “How different treatment options work (χ2 = 0.02)” and “How much time is required to complete treatment (χ2 = 0.04).” Conclusions: These results suggest that many prostate cancer patients do not receive all of the information they deem important for treatment decision-making. Treatment information seeking behavior appears to be an emerging area of disparity for African Americans and men with lower income. Patient centered interventions need to be developed and implemented to reduce unmet treatment information needs within these medically underserved populations. Citation Format: Jarrett Johnson, Sarbesh Pandeya, Ahmed Kabore, Stuart H. Tedders, Levi Ross. Examining sociodemographic differences in unmet treatment information needs among localized prostate cancer survivors. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A54.

The barbershop is a promising setting where African-American men might receive information and education about prostate cancer. In this study, we assessed the feasibility of engaging rural barbershops as venues for barbers to deliver a prostate cancer education intervention to increase informed decision-making for prostate cancer screening among customers. Twelve barbershops were recruited from two separate micropolitan areas in Georgia as intervention and control sites. Structured interviews were conducted with 11 barbers in both sites about customer characteristics as well as their willingness to participate in the study. The interviews were audio recorded and transcribed for analysis. In the intervention site, six barbers completed a survey and a pre-/posttest prostate cancer knowledge instrument following training classes. Barbers reported a wide average range of customers served per week (50 to 300). African-American men made up an average of 87% of customers. Barbers thought prostate cancer was an important discussion topic, felt they would be comfortable discussing it, and supported the participation of their barbershop in the study. For intervention group barbers, there was a statistically significant difference between the average pretest knowledge score of 72% (mean 12.2, SD=3.2) and the posttest knowledge score of 89% (mean 15.2, SD=1.1) (P=0.03) on the 17-item prostate cancer knowledge instrument. Based on the multiple interactions with the barbers, there was high receptivity to the topic and consensus about the importance of addressing prostate cancer with their customers. Rural barbershops represent feasible venues for delivering a prostate cancer education intervention.

The barbershop has been portrayed as a culturally appropriate venue for reaching Black men with health information and preventive health screenings to overcome institutional and socio-cultural barriers. The purpose of this review is to synthesize the peer-reviewed literature on barbershop-based health programs to provide lessons learned for researchers and practitioners. A literature search was conducted to identify articles for the review. Inclusion criteria specified that studies had to be based in the United States and reported about research where barbers were either being assessed for the feasibility of their participation or recruited to administer health education/screening outreach or research activities. The literature search produced 901 unique bibliographic records from peer-reviewed publications. After eliminating articles not meeting the inclusion criteria, 35 articles remained for full-text review. The final article sample consisted of 16 articles for complete abstraction to assess characteristics of studies, role and training of barbers, outcomes targeted, effectiveness, and key findings. All barbershop-based studies reviewed targeted Black men in urban settings. Common study designs were cross-sectional studies, feasibility studies, needs assessments, and one-shot case studies. Barber administered interventions addressed primarily prostate cancer and hypertension, and barbers provided health education, screening, and referrals to health care. Nonintervention studies focused mostly on surveying or interviewing barbers for assessing the feasibility of future interventions. Barbershops are a culturally appropriate venue for disseminating health education materials in both print and media formats. Barbershops are also acceptable venues for training barbers to conduct education and screening. In studies where barbers received training, their knowledge of various health conditions increased significantly and knowledge gains were sustained over time. They were also able to increase knowledge and promote positive health behaviors among their customers, but these outcomes were variable and not consistently documented.

Purpose: All men diagnosed with prostate cancer must undergo the complex process of treatment decision-making. Research indicates that most men are not prepared to fully interact with the information environment when they are initially diagnosed. The reasons behind this lack of preparedness are not fully understood. More information is needed about psychosocial facilitators and barriers to information gathering before appropriate interventions can be developed. The purpose of this research was to explore the different types of psychosocial assistance that men might need to help them begin gathering treatment information. Methods: A purposive sample of 63 African-American and Caucasian men treated for or actively monitoring localized prostate cancer (Stage T1 or T2) was recruited to participate. All recruitment was completed via cancer registries, newspaper ads, and word-of-mouth. All participants completed a 30-45 minute self-administered survey on a laptop or touchscreen computer. Data collected included: (1) demographic information and (2) information about their self-reported levels of (a) confidence, (b) confusion, (c) worry, (d) comfort, (e) ease, and (f) organization during their initial searches for treatment information. All men received a $25.00 honorarium for participating. Results: The mean age of participants was 64.17 years. Participants were between six months to 10 years post prostate cancer diagnosis (mean = 5.21 years, SD= 3.23). At the initial search for treatment information, the majority of men (82.5%) were not confident they knew all of the right information to look for and were not confident they could find answers for all of their questions (79.3%). When psychosocial barriers were compared by race, one significant relationship was found. A greater proportion of African Americans (19.2%) found the initial information gathering process more difficult than their Caucasian counterparts (13.5%) (p < .05). Conclusions: Knowing what to look for and where to find answers is a common problem for both African American and Caucasian prostate cancer patients. Interventions need to be developed that make initial searches for information easier for African-American men. Citation Format: Heather Guerreso, Jarrett Johnson, Levi Ross. Racial differences in psychosocial barriers to initiate prostate cancer treatment information seeking. [abstract]. In: Proceedings of the Eighth AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 13-16, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2016;25(3 Suppl):Abstract nr A45.

Purpose To evaluate the applicability of an evidence-based video intervention to promote informed decision making for prostate cancer screening among African American men with different levels of health literacy. Methods Forty nine African American men participated in interviewer-administered, pretest and posttest interviews between January and March 2008. Health literacy status was assessed with the Test of Functional Health Literacy in Adults. Repeated measures analysis of covariance (ANCOVA), McNemar or binomial distributions were computed to assess pretest and posttest differences in knowledge. Descriptive statistics were produced to describe participants' perceptions of the information presented in the video. Results Results indicated that men with functional health literacy had higher mean levels of prostate cancer screening knowledge at baseline than men with inadequate health literacy. The between-group (F 2,44 = 4.84; p = .013) and within-group (F 1,44 = 5.16; p = .028) test results from repeated-measures ANCOVA indicated that preexisting group differences in prostate cancer knowledge had lessened after intervention exposure. Nearly all men rated the information presented in the video as credible (98%), trustworthy (96%), interesting (100%), understandable (94%), and complete (96%). Conclusions Results from this exploratory study suggest that the video intervention is suitable for use with African American men with different health literacy characteristics in 2 counties in the greater Florida panhandle region. More research is recommended to evaluate the impact of the intervention on men's intentions to undergo screening and actual screening behavior.

Mortality rates for coronary heart disease (CHD) have declined markedly since the early 1970s. However, CHD remains the number one cause of death in the United States. The decline in mortality has been attributed to declines in CHD risk factors (tobacco use, hypertension) and the increase in protective behaviors (exercise, weight control). Medical interventions may have also contributed to the decline in mortality. Despite these declines in mortality, racial disparities persist between Blacks and Whites. The purpose of this study was to examine the differences in receipt of cardiac catheterization, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft.Data from the National Hospital Discharge Survey were used for the analysis. Patients who were Black or White andor = 40 years of age were included. Independent variables included age at discharge, sex, race, and insurance coverage. Multivariate logistic regression was used to derive odds ratios for the receipt of the three procedures by age group, sex, insurance type, and race.Significant differences (P.05) in the odds of receipt of all of cardiac catheterization, percutaneous transluminal coronary angioplasty, and coronary artery bypass graft were found by age group, insurance type, sex, and race. While the disparities persisted from 1979 to 2004, the magnitude of the differences decreased during this time period.Disparities by race, sex, and insurance type existed in the receipt of three cardiac procedures. Although differences are narrowing over time, further in-depth studies are needed to elucidate the patient, physician, and healthcare system factors associated with the disparity in receipt of these beneficial procedures.

Public health actions to improve African American men's ability to make informed decisions about participation in prostate cancer control activities have a greater likelihood of success when they are theory driven and informed by members of the target population. This article reports on formative research to evaluate the usefulness of the theory of reasoned action as a model to explain and predict prostate cancer information-seeking behavior by African American men. Fifty-two men participated in eight focus group interviews. Positive behavioral beliefs for obtaining prostate cancer information from physicians included increasing awareness of and obtaining accurate information about the disease, early detection and screening, and treatment. Negative beliefs included fear, distrust, and inconvenience. Significant others, peers, siblings, and religious leaders were identified as individuals who could influence this behavior. These findings provide additional insight into ways to reach and intervene with African American men to influence this important cancer control activity.

Background: While it is recognized that multiple factors interact at different socioecological levels to influence cancer disparities, many of the proposed solutions to eliminating disparities have been narrowly focused on individual level factors. Social networks have been shown to influence health outcomes through various pathways, including shared social capital, social and cultural norms, risky behaviors, and the transmission of infectious diseases. Current research has shown how social networks influence health behavior; however there are still some critical gaps in this understanding. There is lack of data about social networks and the context in which individuals make decisions about their medical care and health behavior. The purpose of this study is to explore how certain sociocultural conditions influence the composition and nature of social networks structure; and how in turn these networks serve as mediating structures for certain psychosocial mechanisms that influence decisions about screening health behaviors. Methods: Social network analysis of egocentric networks was conducted to visualize the social networks of 65 African American, Latino, and Caucasian men and women. Descriptive statistics (e.g. frequencies, proportions, and means) will be produced to describe sample characteristics in terms of screening behaviors performed/not performed, network sizes, and flow of information. Bivariate statistics (e.g., Chi-square, Mc Nemar, t-tests, ANOVAs) will be computed to make comparisons on these variables by racial/ethnic group membership. Multivariate statistics will be computed to evaluate the impact of social network characteristics on screening practices, health decisions, and access to health care. Results: Our analysis allows us to describe the structural and compositional network characteristics that are related to prostate, breast, and colorectal cancer screening, and explore whether there is variation in the ways that social network characteristics influence cancer screening behaviors. Our analysis explores the structural and compositional measures of the network (e.g., size, density, strength of ties) and associations among sociocultural conditions, the composition and nature of social networks structure and how in turn these networks serve as mediating structures for certain psychosocial mechanisms that may influence decisions about cancer screening health behaviors. Conclusion: Social network analysis has the potential to provide measureable data to help characterize how individuals interact with and access cancer screening services and other key variables that impact health risk behaviors. Before evidenced-based, multi-level interventions can be developed to improve prostate, breast, and colorectal cancer screening, more scientific knowledge is needed about how interpersonal factors shape these screening behaviors. Citation Format: Essie Torres, Levi Ross, Jarrett Johnson. The feasibility of using social networks to understand the causal pathways of cancer disparities. [abstract]. In: Proceedings of the Sixth AACR Conference: The Science of Cancer Health Disparities; Dec 6–9, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2014;23(11 Suppl):Abstract nr A70. doi:10.1158/1538-7755.DISP13-A70

B13 Initiatives to promote informed decision making for prostate cancer (CaP) screening and early detection have grown significantly in recent years. However, several subpopulations of men throughout the United States remain underserved. Systematic reviews of the CaP control literature point to a need for more research to enhance African American mens’ knowledge of CaP screening issues and research that can increase their levels of participation in CaP screening decision-making discussions with physicians. Evidenced-based tools exist that can achieve both of these objectives. However, many of these tools have not been evaluated for use with African American men nor with consideration given to participants’ abilities to comprehend health messages as measured by health literacy status. The current research study was conducted in response to national calls for more type II translation research--research aimed at increasing the adoption of effective practices into communities--with vulnerable and high risk populations. The goal was to evaluate the applicability of a video intervention-The PSA Test for Prostate Cancer: Is it Right for Me?--for use with African American men in the Greater Florida Panhandle Region. The specific aims were (1) to assess acceptability of the intervention, (2) to evaluate the impact of the intervention on knowledge about screening-related issues, and (3) to assess the impact of the intervention on intentions to become involved in decision-making discussions across participants’ demographic and health literacy characteristics. Fifty African American men participated in interviewer-administered pretest/posttest interviews during January and February 2008. Health literacy status was determined with the test of functional health literacy in adults (TOFHLA). Six research hypotheses related to changes in CaP knowledge, intentions to engage in PSA screening decision-making discussions, and intentions to undergo PSA testing were tested. Results from bivariate analyses [F(2,46) = 6.54, p = .003] indicated that men with functional health literacy (M = 7.29) had higher mean levels of CaP knowledge at baseline than men with inadequate health literacy (M = 5.50). No baseline differences were noted regarding participants’ intentions to have PSA discussions with physicians in the next 12 months or their intentions to have a PSA test in the next 12 months. The between group and within group test results from repeated measures analysis of covariance indicated that the group differences in CaP knowledge that existed at pretest had lessened after intervention exposure. No changes were found regarding participants’ intentions to have a PSA discussion with a physician in the next 12 month or their intentions to have a PSA test. Participants’ perceptions of the information presented in the video were overwhelmingly favorably. Nearly all (98%) believed the information was credible. Ninety percent stated that the information was trustworthy. All men thought the information was interesting. Most (91%) stated that the information was understandable. Nearly all (96%) thought the information presented was complete. Results from the current study provide preliminary support for the use of an evidenced-based intervention with diverse African American men and support more dissemination research with the intervention within the African American community. Citation Information: Cancer Prev Res 2008;1(7 Suppl):B13.

Racial and ethnic disparities have been reported in clinical trial/research participation, utilization of autologous and allogeneic blood and marrow transplantation (BMT), and availability of allogeneic donors. We performed a population-based cohort study to investigate adult hematologic malignancy referrals to a US tertiary cancer center, utilization of BMT, and participation in clinical trial, survey, and biospecimen research by race. US Census Data and the New York State Public Access Cancer Epidemiology Database identified the racial distribution of the general population and new hematologic malignancy cases in the primary catchment area. From 2005 to 2011, 1106 patients aged 18 to 75 years were referred for BMT consultation; although the rate of BMT among hematologic malignancy referrals did not differ by race, the reasons for not receiving a BMT did. Participation in biospecimen research did not vary by race; however, African Americans and other minorities were significantly less likely to participate in survey research than European Americans. Although rates of hematologic malignancy referrals and use of BMT for minorities appear to be low (