African Immigrant Health: Prostate Cancer Attitudes, Perceptions, and Barriers

Abstract

Prostate cancer (PCa) is the second leading cause of cancer-related death among Black men who present with higher incidence, mortality, and survival compared to other racial groups. African immigrant men, however, are underrepresented in PCa research and thus this research sought to address that gap. This study applied a social determinants of health framework to understand the knowledge, perceptions, and behavioral tendencies regarding PCa in African immigrants. African immigrant men and women residing in different parts of the country (California, Texas, Colorado, Oklahoma, and Florida) from various faith-based organizations, African community groups, and social groups were recruited to participate in key informant interviews ( n = 10) and two focus groups ( n = 23). Four themes were identified in this study: (a) PCa knowledge and attitudes—while knowledge is very limited, perceptions about prostate health are very strong; (b) culture and gender identity strongly influence African health beliefs; (c) preservation of manhood; and (d) psychosocial stressors (e.g., financial, racial, immigration, lack of community, and negative perceptions of invasiveness of screening) are factors that play a major role in the overall health of African immigrant men. The results of this qualitative study unveiled perceptions, attitudes, beliefs, and knowledge of PCa among African immigrants that should inform the planning, development, and implementation of preventive programs to promote men’s health and PCa awareness.

A Health Profile of African Immigrant Men in the United States

“…These findings shed light on the challenges faced by AI individuals, particularly in terms of stress, financial strain, and discrimination – all of which negatively impact one's health( Hassan et al., 2021 ; Nkimbeng et al., 2021 ; O'Connor et al., 2021 ). In our sample, 79-percent reported experiencing discrimination, which is consistent with recent literature indicating that the intersectional identity of being both Black and an immigrant exacerbates their discrimination experiences ( Malika et al., 2020 ; Nkimbeng et al., 2021 ). This is critical as studies suggest that AI experiencing discrimination tend to have poorer physical and mental health ( Nkimbeng et al., 2021 ; Szaflarski & Bauldry, 2019 ).…”

“…A large proportion of the AI reported having insurance, visiting a doctor for routine visits regularly, using CAM and expressing distrust in the health system. While an overwhelming majority of the AI in this study had health insurance and had a medical visit at least once a year, several studies ( Malika et al., 2020 ; Omenka et al., 2020 ) have revealed that AI delay office visits until the illness is irrecoverable or severe enough to halt daily functioning. One of the reasons for this has been lack of discussion of CAM integration into health.…”

The Use of Patient-Reported Outcome Measures in Phase I Oncology Clinical Trials

“…Validation of PRO measures is important in demonstrating PRO suitability and may assist in increasing healthcare providers' acceptance of PRO data. Racial differences in completion rates and preferences for the way patients report PROs [38,39] may exist as well. These complexities with PRO data interpretation highlight the need for adaptive approaches, such as adaptive trial designs that minimize the number of patients receiving subtherapeutic doses, and PRO tools that can be tailored accordingly as knowledge on treatment toxicities develops.…”