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Journal of Community Health
Published in: Journal of Community Health 5/2009

01-10-2009 | Original Paper

African American Men’s Understanding and Perceptions About Prostate Cancer: Why Multiple Dimensions of Health Literacy are Important in Cancer Communication

Authors: Daniela B. Friedman, Sara J. Corwin, Gregory M. Dominick, India D. Rose

Published in: Journal of Community Health | Issue 5/2009

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Abstract

Prostate cancer (PrCA) is the most diagnosed cancer among men in the United States, especially among African American (AA) men. The purpose of this formative study was to explore the implications of applying Nutbeam’s multidimensional health literacy framework to AA men’s understanding of PrCA information. Participants were 25 AA men aged 45 and older in South Carolina. Their functional health literacy was assessed using two modified Cloze tests and the Shortened Test of Functional Health Literacy in Adults (S-TOFHLA). Men also participated in interviews or focus groups during which they were asked questions about PrCA risk, prevention, and screening. Transcripts were reviewed for recurrent themes and analyzed qualitatively using NVivo7. Mean S-TOFHLA was 28.28 (±1.98), implying “adequate” comprehension. Mean Cloze was .71 (±.05) for a Grade 8 document and .66 (±.04) for a Grade 13 document, also showing “adequate” comprehension. Cloze scores for the Grade 8 resource were lower for participants with less education (P = .047). Despite having satisfactory literacy test scores, results from interviews and focus groups revealed participants’ limited understanding and misconceptions about PrCA risk. Many wanted information about screening and family history delivered word-of-mouth by AA women and church pastors as few of them had ever received or actively sought out PrCA resources. Using Nutbeam’s framework, gaps in health literacy which were not adequately captured by the validated tools emerged during the interviews and focus groups. Study findings provide important implications for PrCA communication with AA men to correct misperceptions about cancer risk and motivate preventive behaviors.
Literature
1.
American Cancer Society. (2008). Cancer Facts & Figures 2008. Atlanta, GA: American Cancer Society.
2.
Drake, B. E., Keane, T. E., Mosley, C. M., Adams, S. A., Elder, K. T., Modayil, M. V., et al. (2006). Prostate cancer disparities in South Carolina: Early detection, special programs, and descriptive epidemiology. Journal of the South Carolina Medical Association, 102(7), 241–249.
3.
Smith, R. A., Cokkinides, V., & Brawley, O. W. (2008). Cancer screening in the United States, 2008: A review of current American Cancer Society guidelines and cancer screening issues. CA: A Cancer Journal for Clinicians, 58(3), 161–179.CrossRef
4.
US Preventive Services Task Force. (2002). Screening for prostate cancer: Recommendation and rationale. Annals of Internal Medicine, 137(11), 915–916.
5.
Allen, J. D., Kennedy, M., Wilson-Glover, A., & Gilligan, T. D. (2007). African-American men’s perceptions about prostate cancer: implications for designing educational interventions. Social Science & Medicine, 64(1), 2189–2200.
6.
Clarke-Tasker, V. A., & Wade, R. (2002). What we thought we knew: African-American males’ perceptions of prostate cancer and screening methods. The ABNF Journal, 13(3), 56–60.PubMed
7.
Ford, M. E., Vernon, S. W., Havstad, S. L., Thomas, S. A., & Davis, S. D. (2006). Factors influencing behavioral intention regarding prostate cancer screening among older African-American men. Journal of the National Medical Association, 98(4), 505–514.PubMed
8.
Talcott, J. A., Spain, P., Clark, J. A., Carpenter, W. R., Do, Y. K., Hamilton, R. J., et al. (2007). Hidden barriers between knowledge and behavior: the north Carolina prostate cancer screening and treatment experience. Cancer, 109(8), 1599–1606.PubMedCrossRef
9.
Sanchez, M. A., Bowen, D. J., Hart, A., Jr., & Spigner, C. (2007). Factors influencing prostate cancer screening decisions among African American men. Ethnicity and Disease, 17(2), 374–380.PubMed
10.
Sellers, D. B., & Ross, L. E. (2003). African American men, prostate cancer screening and informed decision making. Journal of the National Medical Association, 95(7), 618–625.PubMed
11.
Hoffman-Goetz, L., & Friedman, D. B. (2005). Disparities in the coverage of cancer information in ethnic minority and mainstream mass print media. Ethnicity and Disease, 15(2), 332–340.PubMed
12.
13.
Friedman, D. B., & Hoffman-Goetz, L. (2003). Cancer coverage in North American publications targeting seniors. Journal of Cancer Education, 18(1), 43–47.PubMedCrossRef
14.
Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult Literacy (NCES 2006–483). Washington, DC: National Center for Education Statistics.
15.
16.
Baker, D. W., Gazmararian, J. A., Sudano, J., & Patterson, M. (2000). The association between age and health literacy among elderly persons. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 55(6), S368–S374.
17.
Benson, J. G., & Forman, W. B. (2002). Comprehension of written health care information in an affluent geriatric retirement community: Use of the test of functional health literacy. Journal of Gerontology, 48(2), 93–97.CrossRef
18.
Parikh, N. S., Parker, R. M., Nurss, J. R., Baker, D. W., & Williams, M. V. (1996). Shame and health literacy: The unspoken connection. Patient Education and Counseling, 27(1), 33–39.PubMedCrossRef
19.
Dolan, N. C., Ferreira, M. R., Davis, T. C., Fitzgibbon, M. L., Rademaker, A., Liu, D., et al. (2004). Colorectal cancer screening knowledge, attitudes, and beliefs among veterans: Does literacy make a difference? Journal of Clinical Oncology, 22(13), 2617–2622.PubMedCrossRef
20.
Baker, D. W., Parker, R. M., Williams, M. V., Pitkin, K., Parikh, N. S., Coates, W., et al. (1996). The health care experience of patients with low literacy. Archives of Family Medicine, 5(6), 329–334.PubMedCrossRef
21.
Saha, S. (2006). Improving literacy as a means to reducing health disparities. Journal of General Internal Medicine, 21(8), 893–895.PubMedCrossRef
22.
US Department of Health and Human Services. (2000). Healthy People 2010. With understanding and improving health and objectives for improving health (2nd ed., Vol. 2). Washington, DC: US Government Printing Office.
23.
American Medical Association (Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs). (1999). Health literacy: Report of the Council on Scientific Affairs. Journal of the American Medical Association, 281(6), 552–557.CrossRef
24.
Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259–267.CrossRef
25.
Fischer, M., Visser, A., Voerman, B., Garssen, B., van Andel, G., & Bensin, J. (2006). Treatment decision making in prostate cancer: Patients’ participation in complex decisions. Patient Education and Counseling, 63(3), 308–313.PubMedCrossRef
26.
Denberg, T. D., Melhado, T. V., & Steiner, J. F. (2006). Patient treatment preferences in localized prostate carcinoma: The influence of emotion, misconception, and anecdote. Cancer, 107(3), 620–630.PubMedCrossRef
27.
Berry, D. L., Ellis, W. J., Russell, K. J., Blasko, J. C., Bush, N., Blumenstein, B., et al. (2006). Factors that predict treatment choice and satisfaction with the decision in men with localized prostate cancer. Clinical Genitourinary Cancer, 5(3), 219–226.PubMedCrossRef
28.
Bennett, C. L., Ferreira, M. R., Davis, T. C., Kaplan, J., Weinberger, M., Kuzel, T., et al. (1998). Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer. Journal of Clinical Oncology, 16(9), 3101–3104.PubMed
29.
Kim, S. P., Knight, S. J., Tomori, C., & Colella, K. M. (2001). Health literacy and shared decision making for prostate cancer patients with low socioeconomic status. Cancer Investigation, 19(7), 684–691.PubMedCrossRef
30.
Wolf, M. S., Knight, S. J., Lyons, A., Durazo-Arvizu, R., Pickard, S. A., Arseven, A., et al. (2006). Literacy, race, and PSA level among low-income men newly diagnosed with prostate cancer. Urology, 68(1), 89–93.PubMedCrossRef
31.
Taylor, W. L. (1995). “Cloze procedure”: A new tool for measuring readability. Journalism Quarterly, 30, 415–433.
32.
Baker, D. W., Williams, M. V., Parker, R. M., Gazmararian, J. A., & Nurss, J. (1999). Development of a brief test to measure functional health literacy. Patient Education and Counseling, 38(1), 33–42.PubMedCrossRef
33.
Estey, A., Kemp, M., Allison, S., & Lamb, C. (1993). Evaluation of a patient information booklet. Journal for Nurses in Staff Development, 9(6), 278–282.
34.
Estey, A., Musseau, A., & Keehn, L. (1994). Patient’s understanding of health information: a multihospital comparison. Patient Education and Counseling, 24(1), 73–78.PubMedCrossRef
35.
Busselman, K. M., & Holcomb, C. A. (1994). Reading skill and comprehension of the dietary guidelines by WIC participants. Journal of the American Dietetic Association, 94(6), 622–625.PubMedCrossRef
36.
Friedman, D. B., & Hoffman-Goetz, L. (2007). An assessment of older adults’ comprehension of cancer information on the Internet: Is readability a key factor? Journal of Health Communication, 12(5), 423–437.PubMedCrossRef
37.
Bormuth, J. (1968). The cloze readability procedure. Elementary English, 45, 429–436.
38.
Hafner, L. (1966). Cloze procedure. Journal of Reading, 9, 415–421.
39.
Taylor, W. L. (1957). Cloze readability scores as indices of individual differences in comprehension and aptitude. Journal of Applied Psychology, 41, 19–26.CrossRef
40.
Friedman, D. B., & Hoffman-Goetz, L. (2006). A systematic review of readability and comprehension instruments used for print and web-based cancer information. Health Education & Behavior, 33(3), 352–373.CrossRef
41.
42.
43.
Kincaid, J. P., Fishburne, R. P., Rogers, R. L., & Chissom, B. S. (1975). Derivation of New Readability Formula for Navy Enlisted Personnel. Millington, TN: Navy Research Branch.
44.
Friedman, D. B., Hoffman-Goetz, L., & Arocha, J. F. (2006). Health literacy and the World Wide Web: Comparing the readability of leading incident cancers on the Internet. Medical Informatics & the Internet in Medicine, 31(1), 67–87.CrossRef
45.
SPSS 14.0 [computer program]. (2006). Chicago, IL: SPSS Inc.
46.
Hoffman-Goetz, L., Friedman, D. B., & Celestine, A. (2006). Evaluation of a public library workshop: Teaching older adults how to search the Internet for reliable cancer information. Journal of Consumer Health on the Internet, 10(3), 29–43.CrossRef
47.
QSR NVivo7 [Computer software]. (2006). Melbourne, AU: Qualitative Solutions and Research Pty Ltd.
48.
Strauss, A., & Corbin, J. (1990). Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage Publications.
49.
Glaser, B. G., & Strauss, A. (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. New York, NY: Aldine de Gruyter.
50.
51.
52.
Friedman, D. B., & Hoffman-Goetz, L. (2008). A systematic review of literacy and health literacy definitions for cancer education programs. Health Education Journal, 67(4), 285–304.CrossRef
53.
Porr, C., Drummond, J., & Richter, S. (2006). Health literacy as an empowerment tool for low income mothers. Family & Community Health, 29(4), 328–355.
54.
Tones, K. (2002). Health literacy: New wine in old bottles? Health Education Research, 17(3), 287–290.PubMedCrossRef
Metadata
Title
African American Men’s Understanding and Perceptions About Prostate Cancer: Why Multiple Dimensions of Health Literacy are Important in Cancer Communication
Authors
Daniela B. Friedman
Sara J. Corwin
Gregory M. Dominick
India D. Rose
Publication date
01-10-2009
Publisher
Springer US
Published in
Journal of Community Health / Issue 5/2009
Print ISSN: 0094-5145
Electronic ISSN: 1573-3610
DOI
https://doi.org/10.1007/s10900-009-9167-3

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