Abstract A27: Barbershops: Promoting awareness of prostate cancer among African American men

Aim: African American men experience a disproportionate burden of prostate cancer. While numerous risk factors have been proposed to explain this disparity, our project focused on information needs and assessed the feasibility of using trained barbers for delivering a brief culturally and literacy appropriate prostate cancer educational intervention to urban African American men in Tampa, Florida.

Methods: We used a mixed methods design, including in-depth pre- and post-intervention qualitative interviews with eight barbers and a structured survey instrument with 40 barbershop clients in four urban barbershops. Primary outcome measures of the survey were clients' likelihood of discussing prostate cancer screening with a healthcare provider after receiving educational materials and information from their barber and clients' knowledge scores. Survey data were analyzed using standard statistical techniques including the chi-square test for categorical data and the Wilcoxon Signed Ranks test for continuous data. In order to investigate the lay explanatory model of prostate cancer risk factors, cultural consensus analysis methods were employed. This method uses factor analysis to calculate the level of shared knowledge within the group.

Results: The pre-intervention interviews with the barbers found that barbers are viewed by the public as leaders in the community and sources of reliable information, especially when armed with culturally appropriate brochures and posters. Moreover, in the post-intervention interviews, the barbers stated that it was not difficult to engage clients in the project, that serving as a lay health adviser did not interfere with their job as a barber, and that prostate cancer was the most appropriate disease site for a barber-administered educational intervention. Before receiving the prostate cancer education in the barbershop, 75% of participants reported they were “somewhat likely” to “very likely” to discuss prostate cancer with their healthcare provider, but after receiving the education, the proportion increased to 85% (p < .001). There was a significant increase in perceived improvement of self-rated prostate cancer knowledge (p < .001). Results from the cultural consensus analysis suggested a single cultural model of prostate cancer risk factors, with a large ratio of the first to second eigenvalue (9.7). In this model, nonmodifiable risk factors for prostate cancer (age and family history) were classified as categorically different from modifiable risk factors such as diet, exercise, and sexual frequency in the cultural domain.

Conclusion: Results from the survey and the qualitative interviews suggest the feasibility of a barber-administered intervention for increasing prostate cancer awareness and knowledge of prostate cancer in this priority population. Future prostate cancer educational interventions should address distinct cultural belief factors about prostate cancer in order to tailor materials to African Americans.