Intrapersonal and community factors associated with prostate cancer screening among African-American males in the US

Sabrina L Dickey,1 Eileen Cormier,1 James Whyte IV,1 Penny A Ralston2 1College of Nursing, 2Center on Better Health and Life for Underserved Populations, Florida State University, Tallahassee, FL, USA Purpose: The purpose of this research was to examine intrapersonal and community factors associated with prostate cancer screening (PCS) among African-American (AA) males of ≥40 years from a nationally representative data set in the US. The theory of planned behavior was utilized as the theoretical framework. Patients and methods: A cross-sectional secondary analysis employed data from the National Health and Nutrition Examination Survey in the US. The sample consisted of 377 AA males. The primary outcome variables were two PCS tests, the digital rectal exam (DRE) and the prostate-specific antigen test. Logistic regression models were developed to test for associations between the PCS tests and the factors of interest. Results: The factors of age, education, and access to a health care facility were associated with AA males receiving the DRE. The age group of 40–49 years was least likely to receive the DRE when compared to the age group of ≥70 years. Similarly AA males without a college degree were also least likely to receive the DRE when compared to AA males with a college degree. AA males with access to health care were more likely than those without access to receive the DRE. Age <70 years along with church attendance was associated with AA males receiving the prostate-specific antigen test. Conclusion: Differences were present for significant associations among intrapersonal and community variables and the two PCS exams. A culturally sensitive approach is necessary for understanding factors associated with PCS among AA males, which is central to designing and appropriately targeting public health interventions to decrease the health disparity of prostate cancer among this high-risk population. Keywords: prostate cancer screening, prostate cancer, African-American, intrapersonal, community, theory of planned behavio