The association between intrapersonal, interpersonal and community factors and prostate cancer screening among African American men .

Dickey, S.L. (2013). The association between intrapersonal, interpersonal and community factors and prostate cancer screening among African American men (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (UMI No. 3612405)

Disproportionate rates of prostate cancer and high-mortality rates from prostate cancer among African American (AA) men have provided the impetus to examine factors which influence prostate cancer screening (PCS) in the AA male population. This study focused on prostate cancer screening, which included the digital rectal exam (DRE) and the prostate specific antigen (PSA) test as the outcome variables. Literature has indicated an association between intrapersonal, interpersonal, and community factors and prostate cancer screening. In addition, the independent variable of intention was examined as a mediator that links the various factors to the outcome variable of the PSA test. 

Based on the social ecological model and the theory of planned behavior, I hypothesized that: 1) AA men who were over 50 years old, with a college degree, had higher levels of income, a perceived better health-status ranking had higher, positive rates for receiving prostate cancer screening; 2) AA men who were married, and had the presence of marital support, and family support had higher rates of receiving positive prostate cancer screening; 3) higher rates of church attendance, more church member support, and better access to health care would be associated with higher levels of prostate cancer screening; 4) the intrapersonal, interpersonal, and community factors were combined to be associated with the likelihood of AA men receiving prostate cancer screening; and 5) these factors were associated with the likelihood of prostate cancer screening though intention to have a PSA test. 

Using data from the Center of Disease Control and Prevention’s 2007-2008 National Health and Nutrition Examination Survey (NHANES), results from logistic regression suggested that 1) intrapersonal factors were significant and associated with receiving prostate cancer screening ; 2) the interpersonal factors were not significant or associated with AA men receiving prostate cancer screening; 3) community factors were significant and associated with receiving prostate cancer screening; 4) the additive effective of intrapersonal, interpersonal and community factors were significant and associated with prostate cancer screening; and 5) there was no evidence of mediation by intention to receive a PSA test. 

The study adds to the literature on AA men and prostate cancer screening by separately examining three groups of factors that interact with AA men on a personal, social and environmental level. The findings suggested the importance of several factors (age, income, church attendance, and access to health care) that could provide useful information for designing interventions to promote prostate cancer screening among AA men. 

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