Promoting Equity Through a Culturally Tailored Prostate Cancer Genetics Video for African American Males for Impact Long Term: PREVAIL Study
Abstract
Rationale: African American males have some of the highest rates of development and death from prostate cancer in the U.S. Genetic testing for prostate cancer is now central to determining options for therapy in men with metastatic disease with improved outcomes. Genetic results, such as mutations in BRCA2, are also important in guiding more intensive prostate cancer screening strategies due to stronger association to aggressive prostate cancer. However, African American men typically represent fewer than 15% of those who seek and complete genetic testing, creating disparities in the benefit of precision therapies or personalized cancer screening. Furthermore, genetic results provide information on hereditary cancers in families which informs cancer screening and risk management strategies for a host of cancer; this is another benefit of genetic testing that may be limited for African American men and their families if there is less genetic engagement. African American males may participate less frequently in genetic testing due to lack of awareness or understanding of genetic testing, cultural beliefs, financial and access-to-care limitations, fear of discrimination, and distrust in the healthcare system. Furthermore, access to a genetic counselor to understand genetic testing, order testing, and receive full recommendations is increasingly challenging due to a shortage of genetic counselors and unequal regional distribution. Novel strategies in the patient-care setting are needed to enhance engagement and genetic testing for African American men to benefit from precision medicine. The PREVAIL Study builds on novel results from a current genetic testing study by the study team that has shown that using a genetic education video to deliver information about prostate cancer genetic testing leads to high uptake of genetic testing among men, is highly chosen compared to genetic counseling, and leads to high satisfaction with the process, supporting use in practice for rapid initiation of genetic testing. However, 85% of participants in this study were White, pointing to the critical need to engage African American men in the prostate cancer genetic education, counseling, and testing process. Guided by an expert study team, the PREVAIL Study, will develop, test, and disseminate a novel, culturally tailored genetic education video to inform use across healthcare and community settings. The overall goal of the study is to enhance engagement of African American men in prostate cancer genetic testing for the benefit of precision medicine, tailored cancer screening, and hereditary cancer assessment, thus advancing health equity and reducing disparities in prostate cancer. Objective and Aims: Assess the impact of a culturally tailored pretest genetic education video compared to genetic counseling for uptake of genetic testing and patient-reported outcomes among African American men. Aim 1. Create a culturally adapted pretest genetic education video for African American men for sustained use in practice. Informed by our prior research, a culturally tailored video will be developed by a marketing and communications company based in the Philadelphia area with significant experience in developing resources for diverse and underserved populations. Feedback will be obtained from African American men for video refinement. Aim 2. Conduct a patient-choice study of pretest genetic education video vs. genetic counseling, with assessment of process and patient-reported outcomes. African American men referred for prostate cancer genetic testing will have a choice of the pretest video or genetic counseling. Rates of choice, uptake of genetic testing, and men’s experience will be assessed to support use of the video in practice. Aim 3. Develop a dedicated national dissemination action plan for widespread distribution of the culturally tailored pretest video. An expert-driven action plan will be developed for di
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210623
Entities
People
- Veda N Giri
Organizations
- Thomas Jefferson University
- United States Army