Prostate Cancer Clinical Decision Making by Diagnosed and High Risk Latino Men

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DESCRIPTION (provided by applicant): Prostate cancer is the most common noncutaneous cancer and second leading cause of death among men in the United States, and Latinos are the fastest growing minority in the United States. However, low income Latino men are more likely to be uninsured, have less education, and have lower incomes. Many do not speak English as their first language. For these men, much of the available information to help with informed decision-making is not accessible. Because of the lack of consensus on the benefits of screening on prostate cancer mortality or of superior survival benefit of any one treatment for early stage prostate cancer, men are faced with life-altering decisions regarding screening and treatment for those who are diagnosed. Furthermore, men with a first degree relative with prostate cancer are at increased risk. Yet, how the rapidly growing population of Latino men approaches the decision-making process in prostate cancer is virtually unknown. Therefore, the overall purpose of this study is to develop descriptive models of prostate cancer screening, treatment, and diagnosis disclosure decision-making from the perspective of Latino men to form an evidence base for the development of culturally appropriate intervention strategies to facilitate informed and confident decision-making. Specifically, we aim to: 1. Describe the process of deciding on treatment and disclosing diagnosis from the perspective of Latino men who have been treated for prostate cancer and 2. Describe the process of deciding to be screened or not screened for prostate cancer by brothers or sons of Latino men diagnosed with prostate cancer. We will use qualitative descriptive methods to understand prostate cancer treatment, disclosure, and screening decision-making processes from the perspective of Latino men. Both specific aims will be addressed with in-depth individual interviews exploring involvement in and comfort with treatment decision making process, influences on the decision, and disclosure of diagnosis by treated men. For high risk men we will explore risk perception, knowledge and beliefs about prostate cancer screening, sources of information, facilitators and barriers, and decision implementation. Analyses will result in clear, in-depth descriptions that will guide the future development of intervention strategies to facilitate informed decision-making regarding prostate cancer treatment, disclosure, and screening among Latino men facing prostate cancer decisions. PUBLIC HEALTH RELEVANCE: The relevance of this study to public health lies in the fact that Latinos are the fastest growing minority in the United States and Mexican/Mexican-Americans make up over 70% of this growing Latino population. Understanding how treatment, disclosure, and screening decisions are made by Mexican/Mexican-American men from this research will lay the foundation for culturally relevant interventions to assist these men as they face life-altering decisions. Potentially, informed, confident decision-making participation may contribute to better treatment outcomes and appropriate screening for this disadvantaged group of men.