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Luck CC, Bass SB, Chertock Y, Kelly PJA, Singley K, Hoadley A, Hall MJ. Understanding perceptions of tumor genomic profile testing in Black/African American cancer patients in a qualitative study: the role of medical mistrust, provider communication, and family support. J Community Genet 2024; 15:281-292. [PMID: 38366313 PMCID: PMC11217212 DOI: 10.1007/s12687-024-00700-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
Tumor genomic profiling (TGP) examines genes and somatic mutations specific to a patient's tumor to identify targets for cancer treatments but can also uncover secondary hereditary (germline) mutations. Most patients are unprepared to make complex decisions related to this information. Black/African American (AA) cancer patients are especially at risk because of lower health literacy, higher levels of medical mistrust, and lower awareness and knowledge of genetic testing. But little is known about their TGP attitudes or preferences. Five in-person focus groups were conducted with Black/AA cancer patients (N = 33) from an NCI-designated cancer center and an affiliated oncology unit in an urban safety-net hospital located in Philadelphia. Focus groups explored participants' understanding of TGP, cultural beliefs about genetics, medical mistrust, and how these perceptions informed decision-making. Participants were mostly female (81.8%), and one-third had some college education; mean age was 57 with a SD of 11.35. Of patients, 33.3% reported never having heard of TGP, and 48.5% were not aware of having had TGP as part of their cancer treatment. Qualitative analysis was guided by the principles of applied thematic analysis and yielded five themes: (1) mistrust of medical institutions spurring independent health-information seeking; (2) genetic testing results as both empowering and overwhelming; (3) how provider-patient communication can obviate medical mistrust; (4) how unsupportive patient-family communication undermines interest in secondary-hereditary risk communication; and (5) importance of developing centralized patient support systems outside of treatment decisions. Results improve understanding of how Black/AA patients perceive of TGP and how interventions can be developed to assist with making informed decisions about secondary hereditary results.
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Affiliation(s)
- Caseem C Luck
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA, 19122, USA.
| | - Sarah Bauerle Bass
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA, 19122, USA
| | - Yana Chertock
- Department of Clinical Genetics, Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
| | - Patrick J A Kelly
- Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Katie Singley
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA, 19122, USA
| | - Ariel Hoadley
- Risk Communication Laboratory, Department of Social and Behavioral Sciences, Temple University College of Public Health, 1301 Cecil B Moore Ave, Rm 947, Philadelphia, PA, 19122, USA
| | - Michael J Hall
- Department of Clinical Genetics, Cancer Prevention and Control Program, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA
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Garraway IP, Carlsson SV, Nyame YA, Vassy JL, Chilov M, Fleming M, Frencher SK, George DJ, Kibel AS, King SA, Kittles R, Mahal BA, Pettaway CA, Rebbeck T, Rose B, Vince R, Winn RA, Yamoah K, Oh WK. Prostate Cancer Foundation Screening Guidelines for Black Men in the United States. NEJM EVIDENCE 2024; 3:EVIDoa2300289. [PMID: 38815168 DOI: 10.1056/evidoa2300289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND In the United States, Black men are at highest risk for being diagnosed with and dying from prostate cancer. Given this disparity, we examined relevant data to establish clinical prostate-specific antigen (PSA) screening guidelines for Black men in the United States. METHODS A comprehensive literature search identified 1848 unique publications for screening. Of those screened, 287 studies were selected for full-text review, and 264 were considered relevant and form the basis for these guidelines. The numbers were reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Three randomized controlled trials provided Level 1 evidence that regular PSA screening of men 50 to 74 years of age of average risk reduced metastasis and prostate cancer death at 16 to 22 years of follow-up. The best available evidence specifically for Black men comes from observational and modeling studies that consider age to obtain a baseline PSA, frequency of testing, and age when screening should end. Cohort studies suggest that discussions about baseline PSA testing between Black men and their clinicians should begin in the early 40s, and data from modeling studies indicate prostate cancer develops 3 to 9 years earlier in Black men compared with non-Black men. Lowering the age for baseline PSA testing to 40 to 45 years of age from 50 to 55 years of age, followed by regular screening until 70 years of age (informed by PSA values and health factors), could reduce prostate cancer mortality in Black men (approximately 30% relative risk reduction) without substantially increasing overdiagnosis. CONCLUSIONS These guidelines recommend that Black men should obtain information about PSA screening for prostate cancer. Among Black men who elect screening, baseline PSA testing should occur between ages 40 and 45. Depending on PSA value and health status, annual screening should be strongly considered. (Supported by the Prostate Cancer Foundation.).
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Affiliation(s)
- Isla P Garraway
- Department of Urology, David Geffen School of Medicine, University of California and Department of Surgical and Perioperative Care, VA Greater Los Angeles Healthcare System, Los Angeles
| | - Sigrid V Carlsson
- Departments of Surgery and Epidemiology and Biostatistics, Urology Service, Memorial Sloan Kettering Cancer Center, New York
- Department of Urology, Sahlgrenska Academy at Gothenburg University, Gothenburg, and Department of Translational Medicine, Division of Urological Cancers, Medical Faculty, Lund University, Lund, Sweden
| | - Yaw A Nyame
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle
- Department of Urology, University of Washington, Seattle
| | - Jason L Vassy
- Center for Healthcare Organization and Implementation Research (CHOIR), Veterans Health Administration, Bedford and Boston
- Harvard Medical School and Brigham and Women's Hospital, Boston
| | - Marina Chilov
- Medical Library, Memorial Sloan Kettering Cancer Center, New York
| | - Mark Fleming
- Virginia Oncology Associates, US Oncology Network, Norfolk, VA
| | - Stanley K Frencher
- Martin Luther King Jr. Community Hospital and University of California, Los Angeles
| | - Daniel J George
- Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University, Durham, NC
| | - Adam S Kibel
- Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston
| | - Sherita A King
- Section of Urology, Medical College of Georgia at Augusta University and Charlie Norwood Veterans Affairs Medical Center, Augusta, GA
| | - Rick Kittles
- Morehouse School of Medicine, Community Health and Preventive Medicine, Atlanta
| | - Brandon A Mahal
- Sylvester Comprehensive Cancer Center, Miami
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston
| | - Timothy Rebbeck
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston
- Harvard T.H. Chan School of Public Health, Boston
| | - Brent Rose
- Department of Radiation Oncology, University of California, San Diego
- Veterans Affairs San Diego Healthcare System, San Diego, CA
| | - Randy Vince
- Department of Urology, University of Michigan, Ann Arbor
| | - Robert A Winn
- Massey Cancer Center, Virginia Commonwealth University, Richmond
- Department of Internal Medicine, Virginia Commonwealth University, Richmond
| | - Kosj Yamoah
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL
- James A. Haley Veterans' Hospital, Tampa, FL
| | - William K Oh
- Prostate Cancer Foundation, Santa Monica, CA
- Division of Hematology and Medical Oncology, Tisch Cancer Institute at Mount Sinai, New York
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3
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Khan S, Fuzzell L, Langston M, Han Y, Moore JX, Gilbert K, Sutcliffe S, Bensen JT, Mohler JL, Fontham ETH, Song L, Lewis-Thames MW. The impact of marital status on tumor aggressiveness, treatment, and screening among black and white men diagnosed with prostate cancer. Cancer Causes Control 2024; 35:531-539. [PMID: 37919455 PMCID: PMC11323108 DOI: 10.1007/s10552-023-01821-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/27/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE To examine the association of marital status with prostate cancer outcomes in a racially-diverse cohort. METHODS The study population consisted of men (1010 Black; 1070 White) with incident prostate cancer from the baseline North Carolina-Louisiana Prostate Cancer (PCaP) cohort. Marital status at time of diagnosis and screening history were determined by self-report. The binary measure of marital status was defined as married (including living as married) vs. not married (never married, divorced/separated, or widowed). High-aggressive tumors were defined using a composite measure of PSA, Gleason Score, and stage. Definitive treatment was defined as receipt of radical prostatectomy or radiation. Multivariable logistic regression was used to examine the association of marital status with (1) high-aggressive tumors, (2) receipt of definitive treatment, and (3) screening history among Black and White men with prostate cancer. RESULTS Black men were less likely to be married than White men (68.1% vs. 83.6%). Not being married (vs. married) was associated with increased odds of high-aggressive tumors in the overall study population (adjusted Odds Ratio (aOR): 1.56; 95% Confidence Interval (CI): 1.20-2.02) and both Black and White men in race-stratified analyses. Unmarried men were less likely to receive definitive treatment in the overall study population (aOR: 0.68; 95% CI: 0.54-0.85). In race-stratified analyses, unmarried Black men were less likely to receive definitive treatment. Both unmarried Black and White men were less likely to have a history of prostate cancer screening than married men. CONCLUSION Lower rates of marriage among Black men might signal decreased support for treatment decision-making, symptom management, and caregiver support which could potentially contribute to prostate cancer disparities.
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Affiliation(s)
- Saira Khan
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA.
- Epidemiology Program, College of Health Sciences, University of Delaware, 100 Discovery Blvd., 7th floor, Newark, DE, 19713, USA.
| | - Lindsay Fuzzell
- Health Outcomes and Behavior, Moffitt Cancer Center, 12902 Magnolia Dr. MRC-COEE, Tampa, FL, 33612, USA
| | - Marvin Langston
- Department of Epidemiology and Population Health, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Yunan Han
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA
| | - Justin X Moore
- Center for Health Equity Transformation, Department of Behavioral Science, Department of Internal Medicine, Markey Cancer Center, University of Kentucky College of Medicine, 760 Press Avenue, Lexington, KY, 40536, USA
| | - Keon Gilbert
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, St. Louis, University, 3545 Lafayette Ave., Room 316, St. Louis, MO, 63103, USA
| | - Siobhan Sutcliffe
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 8100-0094-02300, 63110, USA
- Alvin J. Siteman Cancer Center, Washington University in St. Louis School of Medicine, 4921 Parkview Place, St. Louis, MO, 63110, USA
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 3130 Bioinformatics Building, CB# 7295, Chapel Hill, NC, 27599, USA
| | - James L Mohler
- Roswell Park Comprehensive Cancer Center, Elm and Carlton St, Buffalo, NY, 14263, USA
| | - Elizabeth T H Fontham
- Department of Epidemiology, School of Public Health, Louisiana State University, 2020 Gravier Street, 3rd Floor, New Orleans, LA, 70112, USA
| | - Lixin Song
- School of Nursing, University of North Carolina - Chapel Hill, Carrington Hall, CB #7460, Chapel Hill, NC, 27599, USA
| | - Marquita W Lewis-Thames
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Dr, Chicago, IL, 60611, USA
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Foster S, Carvallo M, Wenske M, Lee J. Damaged Masculinity: How Honor Endorsement Can Influence Prostate Cancer Screening Decision-Making and Prostate Cancer Mortality Rates. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023; 49:296-308. [PMID: 34964413 DOI: 10.1177/01461672211065293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Prior research has established factors that contribute to the likelihood that men seek out prostate cancer screenings. The current study addresses how endorsing the ideology found in cultures of honor may serve as a barrier to prostate cancer screenings. Two studies were conducted which analyzed the impact of stigma on men's decisions to seek out prostate cancer screenings (Study 1) as well as how prostate cancer deaths may be higher in the culture of honor regions due to men's reticence to seek out screenings (Study 2). Results suggest that older, honor-endorsing men are less likely to have ever sought out a prostate cancer screening due to screening stigma and that an honor-oriented region (southern and western United States) displays higher rates of prostate cancer death than a non-honor-oriented region (northern United States). These findings suggest that honor may be a cultural framework to consider when practitioners address patients' screening-related concerns.
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Affiliation(s)
| | | | | | - Jongwon Lee
- The University of New Mexico, Albuquerque, USA
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Green A, Winter N, DiGiacomo M, Oliffe JL, Ralph N, Dunn J, Chambers SK. Experiences of female partners of prostate cancer survivors: A systematic review and thematic synthesis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1213-1232. [PMID: 34761456 DOI: 10.1111/hsc.13644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this systematic review and synthesis of studies reporting qualitative data was to understand the gendered experiences of female partners of prostate cancer survivors to inform psychosocial support for women. We searched Medline, PsycINFO, EMBASE, AMED, CINAHL, Cochrane Database of Systematic Reviews, and Sociological Abstracts for articles on 15 and 16 April 2019, and again on 30 November 2020. English language articles published in peer-reviewed journals were included if they reported solely on findings describing the perspectives of the female partners. Extracted data were analysed using line-by-line coding, organisation of codes into descriptive themes, and development of analytical themes. A theoretical framework was then selected to organise the relationships between issues that were found to be central to the experiences of female partners. Of 4839 articles screened, 14 met inclusion criteria, reporting 13 studies with a total sample of 359 female partners. Ussher and Sandoval's theory to describe the gendered positionings of cancer caregivers accommodated the thematic findings. The overarching theme reflected the substantive psychosocial impact of prostate cancer on female partners. Women's experiences were influenced by self-positioning (as part of a couple; provider of support to their male partner; resilient; and guided by faith and spirituality), being positioned by their partners' response (manager of male partner's psychological distress or strengthened by male partner's positive response) and by their broader contexts (family members and social networks; clinicians and the health system; and cultural values and customs). Findings highlight the need to avoid reductionist approaches to gender. Greater consideration of 'contextualised femininities', or conceptualising the influence of gender roles, relations, and identities within the wider life course contexts of female partners is required in the design and delivery of psychosocial support services.
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Affiliation(s)
- Anna Green
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Natalie Winter
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Michelle DiGiacomo
- IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - John L Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, University of Melbourne, Victoria, Australia
| | - Nicholas Ralph
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Division of Research and Innovation, University of Southern Queensland, Springfield, Queensland, Australia
- School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Jeff Dunn
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Division of Research and Innovation, University of Southern Queensland, Springfield, Queensland, Australia
- Cancer Council Queensland, Brisbane, Queensland, Australia
- Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia
| | - Suzanne K Chambers
- Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
- Exercise Medicine Research Institute, Edith Cowan University, Perth, WA, Australia
- Faculty of Health Sciences, Australian Catholic University, Brisbane, Australia
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Adegboyega A, Aroh A, Williams LB, Mudd-Martin G. Social support and cervical cancer screening among sub-Saharan African immigrant (SAI) women. Cancer Causes Control 2022; 33:823-830. [PMID: 35426540 DOI: 10.1007/s10552-022-01577-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 03/19/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Low rates of Papanicolaou (Pap) screening among sub-Saharan African immigrant (SAI) women in the US contribute to cancer diagnoses at late stages and high mortality rates. This study was conducted to examine if social support, positively associated with preventive health practices, was predictive of Pap screening in a sample of SAI women. METHODS We conducted a cross-sectional study with SAI women who recently immigrated to the US. Participants completed a survey to assess ever having had Pap screening and social support using the Medical Outcomes Study Social Support Survey. RESULTS Among the 108 SAI women in our study, Pap screening uptake was 65.7%. Affectionate and positive social support were each associated with Pap screening [adjusted odds ratio (AOR) = 1.73 (1.05, 2.87) and 1.68 (1.01, 2.78), respectively]. DISCUSSION These findings suggest that consideration should be given to strengthening certain aspects of social support to increase uptake of Pap screening among SAI women.
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Affiliation(s)
- Adebola Adegboyega
- University of Kentucky, College of Nursing, Lexington, KY, 40536-0232, USA.
- University of Kentucky, 539 College of Nursing Building, Lexington, KY, 40536-0232, USA.
| | | | - Lovoria B Williams
- University of Kentucky, College of Nursing, Lexington, KY, 40536-0232, USA
| | - Gia Mudd-Martin
- University of Kentucky, College of Nursing, Lexington, KY, 40536-0232, USA
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Thomas TH, Hadley ML, Nilsen ML. "I pretty much followed the law, and there weren't any decisions to make": A qualitative study of self-advocacy experiences of men with cancer. Nurs Health Sci 2022; 24:34-43. [PMID: 34850513 PMCID: PMC9169248 DOI: 10.1111/nhs.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 11/28/2022]
Abstract
Current conceptualizations of patient self-advocacy focus on women with cancer, leaving knowledge of male self-advocacy deficient. The purpose of this study is to describe the key components of self-advocacy among men with cancer. Adult (≥18 years old) men with a history of invasive cancer were recruited from cancer clinics and registries. Trained researchers led individual semi-structured interviews regarding participants' challenges, how they overcame those challenges, and barriers and facilitators to their self-advocacy. All interviews were analyzed using descriptive content analysis methods and synthesized into major themes. These themes were refined after receiving feedback from key stakeholders. Participants (N = 28) reported three major self-advocacy themes: (i) managing through information and planning; (ii) finding the best team and falling in line; and (iii) strategic social connections. These themes are richly described with representative quotations for each theme and subtheme. Based on these findings, existing models of patient self-advocacy should be adjusted to encompass how men self-advocate. Clinicians should consider how gender may impact how and why patients with cancer self-advocate so that they can best support their patients in achieving patient-centered care.
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Affiliation(s)
- Teresa Hagan Thomas
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA,Palliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Makenna L. Hadley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Marci Lee Nilsen
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA,Department of Otolaryngology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Cho D, Milbury K, Liao Y, Pettaway CA, Gregg JR, Li Y, McNeill LH. Study protocol: One plus one can be greater than two-Ecological momentary assessment for Black prostate cancer survivors and partners. PLoS One 2021; 16:e0255614. [PMID: 34370761 PMCID: PMC8351991 DOI: 10.1371/journal.pone.0255614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/18/2022] Open
Abstract
Given that romantic partners play a pivotal role in patients' survivorship period, integrating partners into survivorship care and broadening the focus of behavioral interventions from the individual (survivor) to the survivor-partner dyad may make healthy lifestyle behaviors more easily adopted and potentially maintained. Understanding the role of dyadic processes in Black survivors is particularly important because their lifestyle behaviors are poor and they have higher cancer-specific and all-cause mortality. To develop an effective dyadic lifestyle behavior intervention for Black survivors, micro-level investigations of interactions between Black survivors and their partners are necessary to pinpoint how survivors and partners facilitate or hinder each other's lifestyle behaviors in their natural, everyday lives. Accordingly, the objective of the present study is to fill these gaps using ecological momentary assessment to eventually develop more effective lifestyle interventions for Black prostate cancer (PCa) survivors and partners. A total of 120 dyads (i.e., 240 individuals) who are Black adult survivors diagnosed with non-metastatic PCa and their romantic partners will be asked to complete four assessments per day for 14 consecutive days on a smartphone after an initial retrospective survey. Over the 14 days, participants will be asked to complete a brief survey regarding their lifestyle behaviors (physical activity, sedentariness and eating behaviors), contexts of lifestyle behaviors, stress, and coping. Physical activity and sedentary behavior will be assessed via accelerometer; eating behaviors will be assessed with the Automated Self-Administered 24-hour Dietary Assessment Tool. After completing the 14-day assessment, participants will be asked to complete a final retrospective survey. Results of the proposed study will inform the rigorous development of a theory-based dyadic lifestyle intervention in this vulnerable survivorship population with the ultimate goal to improve overall survival and reduce morbidities (for survivors) and reduce cancer incidence (for partners).
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Kathrin Milbury
- Department of Behavioral Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Yue Liao
- Department of Kinesiology, The University of Texas at Arlington, Dallas, Texas, United States of America
| | - Curtis A. Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Justin R. Gregg
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Lorna H. McNeill
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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9
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Armstrong N, Quek RGW, Ryder S, Ross J, Buksnys T, Forbes C, Fox KM, Castro E. DNA damage repair gene mutation testing and genetic counseling in men with/without prostate cancer: a systematic review. Future Oncol 2021; 17:853-864. [DOI: 10.2217/fon-2020-0569] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Ongoing clinical trials are investigating PARP inhibitors to target the DNA damage repair (DDR) pathway in prostate cancer. DDR mutation screening will guide treatment strategy and assess eligibility for clinical trials. Materials & methods: This systematic review estimated the rate of DDR mutation testing or genetic counseling among men with or at risk of prostate cancer. Results: From 6856 records, one study fulfilled the inclusion criteria and described men undiagnosed with prostate cancer with a family history of BRCA1/2 mutation who received DDR mutation testing. Conclusion: With only one study included in this first systematic review of DDR mutation testing or genetic counseling in men with or at risk of prostate cancer, more research is warranted.
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Affiliation(s)
| | | | | | | | | | | | - Kathleen M Fox
- Strategic Healthcare Solutions, LLC, Aiken, SC 29803, USA
| | - Elena Castro
- Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga (IBIMA), Spain
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Stewart SJ, Roberts L, Brindle L. Romantic partner involvement during oncology consultations: A narrative review of qualitative and quantitative studies. PATIENT EDUCATION AND COUNSELING 2021; 104:64-74. [PMID: 32868161 DOI: 10.1016/j.pec.2020.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To review the currently available research into romantic partner involvement during oncology consultations. METHODS Studies were identified via database searches plus hand-searching. A narrative review was performed using the principles of Thematic, and Framework syntheses. The search strategy was performed according to the principles of PRISMA. RESULTS From 631 results, 18 studies were included. The findings indicate that romantic partners are most valued by patients when they provide emotional, practical, and informational support. It is also indicated that psychosocial and sexual concerns are rarely discussed. Couples' self-reported satisfaction with consultations appear related to the extent of romantic partner involvement, the roles that they enacted, and the extent to which psychosocial and sexual concerns were addressed. CONCLUSION This review indicates that romantic partner involvement during clinical consultations enhances the couple's experience. However, there are methodological limitations to this body of research, which are discussed in this review. PRACTICE IMPLICATIONS Research to date has yet to offer an exploration of the social practices and conversational actions relating to romantic partner involvement during triadic oncology consultations. Future studies that draw upon recordings of these consultations, using methods capable of analysing situated social practices can address this gap.
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Affiliation(s)
- Simon John Stewart
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK.
| | - Lisa Roberts
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK.
| | - Lucy Brindle
- School of Health Sciences, Faculty of Environment and Life Sciences, University of Southampton, Southampton, UK.
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11
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Cho D, Basen-Engquist K, Acquati C, Pettaway C, Ma H, Markofski M, Li Y, Canfield SE, Gregg J, McNeill LH. Cultural Adaptation of Evidence-Based Lifestyle Interventions for African American Men With Prostate Cancer: A Dyadic Approach. Am J Mens Health 2020; 14:1557988320945449. [PMID: 33148111 PMCID: PMC7653295 DOI: 10.1177/1557988320945449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022] Open
Abstract
Although a number of lifestyle interventions have been developed for cancer survivors, the extent to which they are effective for African American men with cancer is unclear. Given that African American men have the highest prostate cancer burden and the lack of proven interventions, this study developed a culturally-tailored lifestyle intervention for African American men with prostate cancer and their partners that aimed to improve healthy lifestyle behaviors (physical activity and healthy eating) and quality of life. The aim of the present study is to provide a detailed overview of the model-based process of intervention adaptation. Based on the IM Adapt approach (Highfield et al., 2015) and Typology of Adaptation (Davidson et al., 2013), the present study adapted existing, evidence-based interventions to address African American prostate cancer survivors' and their partners' potential unmet needs including anxiety/uncertainty about cancer progression, communication between partners, cultural sensitivity, and concordance/discordance of motivation and behaviors between partners. The intervention adaptation was a comprehensive and fluid process. To the best knowledge of the author, this is the first couple-based lifestyle intervention specifically developed for African American men with prostate cancer. The present study will be highly informative to future investigators by providing flexible and detailed information regarding lifestyle intervention adaptation for racial/ethnic minority men with prostate cancer and their partners.
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Affiliation(s)
- Dalnim Cho
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | | | - Curtis Pettaway
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | - Hilary Ma
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | - Yisheng Li
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
| | | | - Justin Gregg
- University of Texas MD Anderson
Cancer Center, Houston, TX, USA
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Cho D, Basen-Engquist K, Acquati C, Ma H, Pettaway C, Li Y, Diep CS, McNeill LH. Study protocol: a lifestyle intervention for African American and Hispanic prostate cancer survivors on active surveillance and their partners. Pilot Feasibility Stud 2020; 6:111. [PMID: 32782817 PMCID: PMC7414583 DOI: 10.1186/s40814-020-00653-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 07/30/2020] [Indexed: 11/17/2022] Open
Abstract
Background Prostate cancer is the most commonly diagnosed cancer in both African American and Hispanic men. Active surveillance is a treatment option for low- or very low-risk prostate cancer survivors, and lifestyle interventions have been found to reduce the disease progression and improve the quality of life for both survivors and their partners. To date, no lifestyle interventions that specifically target African American or Hispanic men and their partners exist. This protocol describes a study that tests the feasibility of a randomized controlled trial, a lifestyle intervention developed to enhance healthy lifestyle and quality of life among African American and Hispanic men on active surveillance and their partners. Methods A mixed-method study, including a two-arm randomized controlled trial (n = 30 dyads in the intervention arm and n = 10 dyads in the control arm) and in-depth interviews, will be conducted. Intervention arm participants will receive bi-weekly health coaching calls (a total of 12 calls based on Motivational Interviewing), as well as physical activity-specific (e.g., power point slides, print materials about physical activity, and activity trackers for self-monitoring) and nutrition-specific education (e.g., two nutrition counseling sessions from a registered dietitian, print materials about nutrition, and food intake recording for self-monitoring) over 6 months. All participants will be assessed at baseline, month 3, and month 6. Blood will be collected at baseline and month 6 from the prostate cancer survivors. Finally, in-depth interviews will be conducted with subsamples (up to n = 15 dyads in the intervention arm and up to n = 5 dyads in the control arm) at baseline and months 3 and 6 to conduct a process evaluation and further refine the intervention. Discussion If effective, the intervention may have a higher health impact compared with a typical lifestyle intervention targeting only survivors (or partners), as it improves both survivors’ (tertiary prevention) and partners’ health (primary prevention). Results from this study will provide important information regarding recruiting racial/ethnic minority cancer survivors and their partners. Lessons learned from this study will be used to apply for a large-scale grant to test the impact of the dyadic intervention in a fully powered sample. Trial registration ClinicalTrials.gov (NCT No. 03575832) registered on 3 July 2018.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, UT Texas MD Anderson Cancer Center, 1400 Pressler St, 9th floor, Houston, TX 77030 USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX USA
| | - Hilary Ma
- Department of General Oncology, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Curtis Pettaway
- Department of Urology, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | - Yisheng Li
- Department of Biostatistics, UT Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Lorna H McNeill
- Department of Health Disparities Research, UT Texas MD Anderson Cancer Center, 1400 Pressler St, 9th floor, Houston, TX 77030 USA
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Langford AT, Scherer LD, Ubel PA, Holmes-Rovner M, Scherr KA, Fagerlin A. Racial differences in veterans' response to a standard vs. patient-centered decision aid for prostate cancer: Implications for decision making in African American and White men. PATIENT EDUCATION AND COUNSELING 2020; 103:S0738-3991(20)30322-0. [PMID: 32591257 DOI: 10.1016/j.pec.2020.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To determine whether racial differences exist in patient preferences for prostate cancer treatment after being informed about options using a patient-centered vs. a standard decision aid (DA). METHODS This article reports secondary analyses of a large study of men diagnosed with early stage prostate cancer. Men were recruited from 4 VA Health Systems and randomized to receive a patient-centered or standard DA about prostate cancer treatment options. Data were collected at 1) baseline, 2) after reading the DA but prior to diagnosis, and 3) after receiving a cancer diagnosis and meeting with a urologist. RESULTS White patients who received the patient-centered DA written at a 7th grade reading level were more likely to prefer active surveillance and less likely to prefer radiation compared to those who received the standard DA written at >9th grade reading level. African American patients' treatment preferences did not differ as a function of DA. CONCLUSIONS When informed about prostate cancer treatment options through a patient-centered DA, White patients changed their treatment preferences but African American patients did not. PRACTICE IMPLICATIONS As DAs are increasingly being used in clinical practice, more research is needed regarding the efficacy, relevance, and receptivity of DAs for African Americans.
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Affiliation(s)
- Aisha T Langford
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Clinical and Translational Science Institute, New York University Grossman School of Medicine, New York, NY, USA.
| | - Laura D Scherer
- Division of Cardiology, University of Colorado School of Medicine, Denver, CO, USA; Colorado Program for Patient Centered Decisions at ACCORDS, University of Colorado School of Medicine, Denver, CO, USA
| | - Peter A Ubel
- Department of Medicine, Duke University Medical Center, Durham, NC, USA; Fuqua School of Business, Duke University, Durham, NC, USA; Sanford School of Public Policy, Duke University, Durham, NC, USA
| | - Margaret Holmes-Rovner
- Center for Ethics and Department of Medicine, Michigan State University, East Lansing, MI, USA
| | - Karen A Scherr
- Fuqua School of Business, Duke University, Durham, NC, USA; Department of Family Medicine and Community Health, Duke University Medical Center, Durham, NC, USA
| | - Angela Fagerlin
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA; Salt Lake City VA Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation, Salt Lake City, UT, USA
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