The Health Seeking Behaviors of Young African American Males and Their Thoughts About Prostate Cancer Veronica A. Clarke-Tasker, Ph.D., RN, MBA, MPH, Professor Howard University College of Pharmacy, Nursing & Allied Health Sciences Research Funded by Agency for Health Care Research & Quality

Incidence and Mortality Year 2009 An estimated 27,130 (34%) African American men will be diagnosed this year with prostate cancer Approximately 3,690 (12%) men will die from this disease; that is Approximately 10 deaths per day

PURPOSE The purpose of this study, which is on going, is to explore young African American males health seeking behaviors and their thoughts about prostate cancer.

METHODOLOGY Two focus groups were conducted with nineteen African American men with a mean age of 35 years in a local community.

RECRUITMENT OF SUBJECTS Subjects who met the study criteria were advised of the purpose of the study and asked to participate by the researchers

METHODOLOGY Informed Consent was obtained Subjects completed a draft of a prostate cancer survey for use with young African American men Focus groups were facilitated by the co-investigators

SELECT DEMOGRAPHIC CHARACTERISTS OF THE POPULATION

MARTIAL STATUS Majority of the young men were single living on their own

Level of Education Vocational/training after HS and/or had completed college

INSURANCE COVERAGE The majority of the men did not have health insurance

Their Definition of health Watching what you eat Exercise Mind, body, spirit are complete Knowing your health status Avoiding fatty foods Not hardly every being seek

Their Definition of illness Not being healthy Your body is not operating correctly “not coordinated” Your immune system is being attacked Stress Depression Stomach hurts

The Question…. How often should you have a Complete Physical Examination and how long should it take?

Components of a physical exam “I have one every year, blood pressure, jumping jacks, weight, height, based on your height what you should weight. Basically that took about 10 -15 minutes!”

The “serious” physical exam “I had a serious physical in 25 – 30 minutes!”

The physical examination! “The last physical examination I had was when I was playing football…checked to see if you had any hernia.. hold testicles and ask you to cough, listen to your lung capacity, listen to your heart while taking deep breaths, lasted about 30 minutes.”

Prostate cancer risk 70% of the men in this study did not believe they would develop prostate cancer some time in the future

SCREENING Felt physicians did not screen or suggest that they be screened for prostate cancer

Questions about past family history, prostate or any other cancers Doctor did not talk with me Doctor did not ask me any questions Done of the men in my family talk to me either …not even my old man

THEIR THOUGHTS “men do not want anyone to know that they are having problems below the belly button.”

Attitudes toward MD and DRE “most patients are looking for doctors that give them respect.” “this is just an off limits area”

Attitudes toward MD and DRE “it’s not an old or young thing..it just has to do with being a man.” “it’s taboo,, It’s associated with homosexuality”

Choices “More males are starting to go to females, they feel more comfortable.” “I do it because I rather have them check for the cancer..I just want to get it over with.”

Results – knowledge deficit Did not know their family health history Men did not know the location of the prostate

Results – knowledge deficit Number of fingers used to perform a digital rectal examination – YOUR WHOLE HAND! Symptoms to report to their health care provider

PROSTATE CANCER KNOWLEDGE Younger men had little or no knowledge of prostate cancer and its prevalence within the African American population Did not know the current recommended guideline for prostate cancer screening Did not know and or fully understand methods used for prostate cancer screening

PROSTATE CANCER KNOWLEDGE Considered having a digital rectal examination embarrassing as well as uncomfortable Were not opposed to having a DRE once they understood the purpose

Feelings about having a DRE “If you never been and had that exam or been given the information like what you’re giving and somebody makes jokes about it, it scares you. “

IMPLICATIONS FOR NURSING PRACTICE As nurses we need to educate this high-risk population about prostate cancer and prostate cancer screening methods Anatomically correct models for teaching DRE should be used to aid in alleviating some of the myths associated with the procedure

Questions Thank you for your time and I look forward to your questions