Self-Reported Reasons Men Decide Not to Participate in Free Prostate Cancer Screening
Purpose: To determine the reasons why men fail to participate in a free prostate cancer screening.
Design: Survey and secondary analyses using correlational design.
Setting: Community sites in the Southeastern United States.
Sample: The sample (N = 241) ranged in age from 40-68 years. Mean age was 50 years (SD = 7.4). Most of the men were African American (79%) and married (70%). Almost half of the subjects (44%) earned between $9,601 and $25,020 per year.
Method: Telephone survey of men who did not participate in initial prostate cancer screening after educational program.
Main Research Variables: Demographics, self-reported reasons men decided not to participate in a free screening following a prostate cancer educational program, and predictors for subsequent participation in screening.
Findings: The main self-reported reason for not participating in a free prostate cancer screening opportunity was time problems. A significant relationship between income and physician problems existed among the men who did not participate. Twenty-one percent of the 241 men participated in a second opportunity for free prostate cancer screening. Men who cited "lost packet" as their reason for not participating in the first free screening were more than twice as likely to go for the second opportunity for free screening when offered another packet or voucher for a free screening with their physician of choice.
Conclusions: "Time problems" was the most frequent self-reported reason men gave for failure to participate. Providing a follow-up phone call and vouchers a second time for reimbursement of the cost associated with a screening increased participation. Men often need assistance with locating physicians and nurse practitioners who will file for financial reimbursement. Appointment reminders are critical.
Implications for Nursing: The findings of this study of the significant relationship between income and "physician problems" for not participating has implications for healthcare providers. Future programs could provide telephone follow-up with men and remail vouchers, as needed. In addition, men could be encouraged to designate one place in their households for health-related papers (for safekeeping).
Abbott, R.R., Taylor, D.K., & Barber, K. (1998). A comparison of prostate knowledge of African American and Caucasian men: Changes from prescreening baseline to post intervention. <i>Cancer Journal from Scientific American, 4</i>, 175-177.
American Cancer Society. (1990). Report to the nation: Cancer in the poor. <i>CA: A Cancer Journal for Clinicians, 39</i>, 263-265.
Demark-Wahnefried, W., Strigo, T., Catoe, K., Conaway, M., Brunetti, M., & Rimer, B.K. (1995). Knowledge, beliefs, and prior screening behavior among blacks and whites reporting for prostate cancer screening. <i>Urology, 46</i>, 346-351.
Etzioni, R., Legler, J.M., Feuer, E.J., Merrill, R.M., Cronin, K.A., & Hankey, B.F. (1999). Cancer surveillance series: Interpreting trends in prostate cancer—Part III: Quantifying the link between population prostate-specific antigen testing and recent declines in prostate cancer mortality. <i>Journal of the National Cancer Institute, 91</i>, 1033-1039.
Eyre, H.J., & Feldman, G.E. (1998). Status report on prostate cancer in African Americans: A national blueprint for action. <i>CA: A Cancer Journal for Clinicians, 48</i>, 315-319.
Feuer, E.J., Merrill, R.M., & Hankey, B.F. (1999). Cancer surveillance series: Interpreting trends in prostate cancer—Part II: Cause of death misclassi-fication and recent rise and fall in prostate cancer mortality. <i>Journal of the National Cancer Institute, 91</i>, 1025-1032.
Jemal, A., Thomas, A., Murray, T., & Thun, M. (2002). Cancer statistics, 2002. <i>CA: A Cancer Journal for Clinicians, 1</i>, 23-47.
Johansson, J.E., Holmberg, L., Johansson, S., Bergstrom, R., & Adami, H.O. (1997). Fifteen-year survival in prostate cancer: A prospective, population-based study in Sweden. <i>JAMA, 277</i>, 467-471.
Labrie, F. (2000). Screening and early hormonal treatment of prostate cancer are accumulating strong evidence and support. <i>Prostate, 43</i>, 215-222.
Mettlin, C.J. (2000). Screening and early treatment of prostate cancer are accumulating strong evidence and support. <i>Prostate, 43</i>, 223-224.
Mettlin, C.J., Murphy, G.P., Rosenthal, D.S., & Mench, H.R. (1998). The national cancer database report on prostate carcinoma after the peak in incidence rates in the U.S. <i>Cancer, 83</i>, 1679-1684.
Myers, R.E. (1999). African American men, prostate cancer early detection examination use, and informed decision-making. <i>Seminars in Oncology, 26</i>, 375-381.
Myers, R.E., Hyslop, T., Wolf, T.A., Burgh, D., Kunkel, E.J.S., & Oyesanmi, O.A. (2000). African American men and intention to adhere to recommended follow-up for an abnormal prostate cancer early detection examination result. <i>Urology, 55</i>, 716-720.
Powell, I.J., Gelfand, D.E., Parzuchowski, J., Heilbrun, L., & Franklin, A. (1995). A successful recruitment process of African American men for early detection of prostate cancer. <i>Cancer Supplement, 75</i>, 1880-1884.
Powell, I.J., Heilbrun, L., Littrup, P.L., Franklin, A., Parzuchowski, J., & Gelfand, D. (1997). Outcome of African American men screened for prostate cancer: The Detroit education and early detection study. <i>Journal of Urology, 58</i>, 146-149.
Ries, L.A.G., Eisner, M.P., Kosary, C.L., Hankey, B.F., Miller, B.A., Clegg. L., et al. (Eds.). (2002). <i>SEER cancer statistics review, 1973-1999.</i> Bethesda, MD: National Cancer Institute.
Shelton, P., & Weinrich, S. (1999). Barriers to prostate cancer screening in African American men. <i>Journal of Black Nurses Association, 10</i>(2), 14-28.
Smith, R.A., von Eschenbach, A.C., Wender, R., Levin, B., Byers, T., Rothenberger, D., et al. (2001). American Cancer Society guidelines for the early detection of cancer: Update of early detection guidelines for prostate, colorectal, and endometrial cancers. <i>CA: A Cancer Journal for Clinicians, 51</i>, 38-75.
Trossman, S. (2000, March/April). Health for all: RN fights to level the playing field. <i>American Nurse, 32</i>, 8-9.
Weinrich, S.P. (2001). The debate about prostate cancer screening: What nurses need to know. <i>Seminars in Oncology Nursing, 17</i>, 78-84.
Weinrich, S.P., Boyd, M., & Powe, B. (1997). Tool adaptation for socioeco-nomically disadvantaged populations. In M. Stromborg & S. Olsen, (Eds.) <i>Instruments for clinical nursing research</i> (pp. 20-29). Pittsburgh: Oncology Nursing Society.
Weinrich, S.P., Ellison, G., Boyd, M.D., Hudson, J., Bradford, B., & Weinrich, M.C. (2000). Participation in prostate cancer screening among low-income men. <i>Psychology, Health, & Medicine, 5</i>, 439-450.
Weinrich, S.P., Reynolds, W.A., Tingen, M.S., & Starr, C.R. (2000). Barriers to prostate cancer screening. <i>Cancer Nursing, 23</i>, 117-121.
Weinrich, S.P., Weinrich, M., Atwood, J., & Cobb, M. (1999). Cost for prostate cancer educational programs by race and educational method. <i>American Journal of Health Behavior, 23</i>, 144-156.
Weinrich, S.P., Weinrich, M.C., Boyd, M.D., & Atkinson C. (1998). The impact of prostate cancer knowledge on cancer screening. <i>Oncology Nursing Forum, 25</i>, 527-534.
Weinrich, S.P., Weinrich, M.C., Boyd, M.D., & Mettlin, C. (1998). Increasing prostate cancer screening in African American men with peer educator and client navigator educational interventions. <i>Journal of Cancer Education, 13</i>, 213-219.
Weinrich, S.P., Weinrich, M.C., Ellison, G., Hudson, J., Reeder, G., & Weissbecker, I. (2000). Contrasting cost of a prostate cancer educational program by income. <i>American Journal of Health Behavior, 24</i>, 422-433.