Peer-Based Intervention for Genetic Evaluation for Prostate Cancer Among African American Men: The Peer Genetic Study Award
Abstract
Rationale: African American males have some of the highest rates of development and death from prostate cancer in the United States. While genetic testing for prostate cancer is rapidly expanding with increasing tests and broader guidelines, African American men typically represent fewer than 10% of those who seek genetic testing. Genetic test results can provide vital information regarding the aggressive nature of prostate cancer, and genetic results are now being used to inform options for targeted therapy in men with metastatic prostate cancer. Furthermore, national guidelines state to consider genetic test results in making decisions for active surveillance among men with early-stage disease, as well as screening decisions among men without prostate cancer. However, African American males may participate less frequently in genetic testing due to lack of awareness or understanding, cultural beliefs, financial and access-to-care limitations, fear of discrimination, and mistrust in the healthcare system. Novel community-based approaches are needed to increase awareness of prostate cancer genetic testing and to help African American males reach an informed decision for consideration of genetic testing, with expected major impact on their prostate cancer screening and treatment plans. Peer navigation has been successfully used in various healthcare settings, such as HIV care or substance abuse, with improved compliance, patient understanding, and outcomes. Genetic evaluation is an area that is ripe for studying peer navigation, particularly in the setting of prostate cancer risk and treatment to address the barriers, beliefs, and needs of African American men and to promote informed engagement in the genetic evaluation process. This effort is now crucial in order to reduce disparities in prostate cancer-related death. The Peer Genetic Study builds upon strong African American community partnerships and an African American male peer health educator network in the Philadelphia region, which has a high percentage of African Americans and exceeds the national average for prostate cancer mortality. The study will conduct focus groups of African American men regarding beliefs, awareness, and challenges to considering genetic testing for prostate cancer to inform training of African American peer health educators. Peer health education will be compared to mailed information on genetic testing among African American male patients from community clinics regarding their comfort with making decisions regarding genetic counseling and genetic testing. The Peer Genetic Study is the first study in the United States dedicated to studying peer navigation to help African American males regarding prostate cancer genetic testing. Objective and Aims: To study the impact of peer navigation on decisional conflict about genetic testing compared to receiving traditional information by mail among African American men. Aim 1. Explore barriers to genetic testing and opportunities for addressing needs among African American males who live in low-resource communities by conducting two focus groups with African American men and interviews with key stakeholders. Aim 2. Train five African American men as peer health educators and implement a randomized trial for 176 African American men in a community clinic setting. Men will be randomized to receive prostate cancer genetic testing information either by (1) a peer health educator or (2) mailed informational materials. Aim 3. Assess the effectiveness of peer health education to deliver prostate cancer genetic testing information. The primary outcome will be decisional conflict regarding consideration of genetic testing. We will also assess the rate at which African American men meet national genetic testing guidelines and, among those who opt for testing, evaluate their satisfaction and experience with the genetic counseling session. Contributions, Applicability, and Impact: Th
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910399
Entities
People
- Veda N Giri
Organizations
- Thomas Jefferson University
- United States Army