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Impact of an Informed Decision Making Intervention among African American Men across Levels of Health Literacy
Cancer Prevention Research (2008)
  • Levi Ross
  • Sherese J. Bleechington
  • Alicestine D. Ashford
  • Deborah O. Erwin
Abstract

Initiatives to promote informed decision making for prostate cancer (CaP) screening and early detection have grown significantly in recent years. However, several subpopulations of men throughout the United States remain underserved. Systematic reviews of the CaP control literature point to a need for more research to enhance African American mens’ knowledge of CaP screening issues and research that can increase their levels of participation in CaP screening decision-making discussions with physicians. Evidenced-based tools exist that can achieve both of these objectives. However, many of these tools have not been evaluated for use with African American men nor with consideration given to participants’ abilities to comprehend health messages as measured by health literacy status. The current research study was conducted in response to national calls for more type II translation research--research aimed at increasing the adoption of effective practices into communities--with vulnerable and high risk populations. The goal was to evaluate the applicability of a video intervention-The PSA Test for Prostate Cancer: Is it Right for Me?--for use with African American men in the Greater Florida Panhandle Region. The specific aims were (1) to assess acceptability of the intervention, (2) to evaluate the impact of the intervention on knowledge about screening-related issues, and (3) to assess the impact of the intervention on intentions to become involved in decision-making discussions across participants’ demographic and health literacy characteristics. Fifty African American men participated in interviewer-administered pretest/posttest interviews during January and February 2008. Health literacy status was determined with the test of functional health literacy in adults (TOFHLA). Six research hypotheses related to changes in CaP knowledge, intentions to engage in PSA screening decision-making discussions, and intentions to undergo PSA testing were tested. Results from bivariate analyses [F(2,46) = 6.54, p = .003] indicated that men with functional health literacy (M = 7.29) had higher mean levels of CaP knowledge at baseline than men with inadequate health literacy (M = 5.50). No baseline differences were noted regarding participants’ intentions to have PSA discussions with physicians in the next 12 months or their intentions to have a PSA test in the next 12 months. The between group and within group test results from repeated measures analysis of covariance indicated that the group differences in CaP knowledge that existed at pretest had lessened after intervention exposure. No changes were found regarding participants’ intentions to have a PSA discussion with a physician in the next 12 month or their intentions to have a PSA test. Participants’ perceptions of the information presented in the video were overwhelmingly favorably. Nearly all (98%) believed the information was credible. Ninety percent stated that the information was trustworthy. All men thought the information was interesting. Most (91%) stated that the information was understandable. Nearly all (96%) thought the information presented was complete. Results from the current study provide preliminary support for the use of an evidenced-based intervention with diverse African American men and support more dissemination research with the intervention within the African American community.

Publication Date
November, 2008
Citation Information
Levi Ross, Sherese J. Bleechington, Alicestine D. Ashford and Deborah O. Erwin. "Impact of an Informed Decision Making Intervention among African American Men across Levels of Health Literacy" Cancer Prevention Research Vol. 1 Iss. 7 (Suppl):B13 (2008)
Available at: http://works.bepress.com/levi_ross/52/