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It is well known that prostate cancer in African-American men presents at later stage and at younger age at detection than in Caucasian men. The reasons for this are not entirely clear, but some have hypothesized that this disparity is due to beliefs, attitudes, and behaviors pertaining to prostate screening. In this project, it is assumed that prostate screening behavior in African-American men is affected by a complex web of social and behavioral factors that includes communication and decision-making by their physicians, by the men themselves, and by others in their social and cultural milieu. In addition, it is assumed that there is reason to believe that African American men, as compared to Caucasians, are not participating in discussions with their practitioners about prostate screening. It is arguable that a desirable outcome in prostate screening educaton is getting African American men to have these discussions, in which they are informed of the benefits of screening, and the risks and benefits of the various treatments interventions that are available. Therefore, the goal of this project is to change beliefs and attitudes held by African American men about prostate cancer screening such that they result in a positive change in behavior: a discussion with a practitioner about screening. To meet this goal, evidence-based research of the literature and focus groups will be used to identify these beliefs and attitudes and the factors that contribute to them. After analyzing these data, they will be used to design a role-playing game-based computerized intervention that is sensitive to these beliefs and attitudes. After implementation, additional testing will be performed by focus groups for system usability, acceptability, and validity of information. It is hypothesized that this intervention will improve knowledge, decrease decisional conflict, improve intention to discuss screening with a practitioner, and increase the incidence of this type of discussion more effectively than traditional printed educational material or no intervention at all. This project represents a novel approach to improving prostate screening that focuses on using a computerized intervention to change patient attitudes and beliefs as they pertain to openness toward discussing screening options with providers.

Key personnel

Name Organization Role on the project

John H. Holmes, Ph.D. University of Pennsylvania Prinicipal Investigator

Carmen Guerra, M.D. University of Pennsylvania Co-investigator

Robert Hornik, Ph.D. University of Pennsylvania Co-investigator

Judy Shea, Ph.D. University of Pennsylvania Co-investigator

Barry G. Silverman, Ph.D. University of Pennsylvania Co-investigator

Xin Tu, Ph.D. University of Pennsylvania Co-investigator/statistician