Adaptation of the socioecological model to address disparities in engagement of Black men in prostate cancer genetic testing.

Autor: Leader AE; Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA., Rebbeck TR; Department of Epidemiology, Harvard TH Chan School of Public Health and Dana-Farber Cancer Institute, Boston, MA, USA., Oh WK; Department of Internal Medicine, Mount Sinai Hospital, New York, NY, USA., Patel AV; Department of Population Science, American Cancer Society, Atlanta, GA, USA., Winer EP; Department of Medicine, Yale Cancer Center and Yale School of Medicine, 333 Cedar Street, WWW214A, New Haven, CT, 06520, USA., Bailey LO; National Cancer Institute/Center to Reduce Cancer Health Disparities, Rockville, MD, USA., Gomella LG; Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA., Lumpkins CY; Department of Communication, Population Sciences Division, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA., Garraway IP; Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA., Aiello LB; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA., Baskin ML; Department of Medicine, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA., Cheng HH; Department of Medicine, Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA., Cooney KA; Department of Medicine, Duke University School of Medicine and Duke Cancer Institute, Durham, NC, USA., Ganzak A; Cancer Genetics and Prevention Program, Yale New Haven Hospital, New Haven, CT, USA., George DJ; Department of Medicine, Duke University School of Medicine and Duke Cancer Institute, Durham, NC, USA., Halabi S; Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, NC, USA., Hathaway F; Department of Medicine, High-Risk and Advanced Prostate Cancer Clinic, University of Chicago Medicine, University of Chicago, Chicago, IL, USA., Healy C; Cancer Genetics and Prevention Program, Yale New Haven Hospital, New Haven, CT, USA., Kim JW; Department of Medicine, Yale Cancer Center and Yale School of Medicine, 333 Cedar Street, WWW214A, New Haven, CT, 06520, USA., Leapman MS; Department of Urology, Yale School of Medicine, New Haven, CT, USA., Loeb S; Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA., Maxwell KN; Department of Medicine-Hematology/Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA., McNair C; Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA., Morgan TM; Department of Urology, Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA., Prindeville B; Neaman Center for Personalized Medicine, NorthShore University Health System, Evanston, IL, USA., Soule HR; Prostate Cancer Foundation, Santa Monica, CA, USA., Steward WL; National Cancer Institute/Center to Reduce Cancer Health Disparities, Rockville, MD, USA., Suttiratana SC; Department of Medicine, Yale Cancer Center and Yale School of Medicine, 333 Cedar Street, WWW214A, New Haven, CT, 06520, USA., Taplin ME; Department of Medicine, Dana-Farber Cancer Institute, Boston, MA, USA., Yamoah K; Departmetnt of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA., Fortune T; Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA., Bennett K; Movember, Santa Monica, CA, USA., Blanding-Godbolt J; Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA., Gross L; Department of Medicine, Yale University and Yale Cancer Center, New Haven, CT, USA., Giri VN; Department of Medicine, Yale Cancer Center and Yale School of Medicine, 333 Cedar Street, WWW214A, New Haven, CT, 06520, USA. Veda.Giri@yale.edu.
Jazyk: angličtina
Zdroj: BMC public health [BMC Public Health] 2024 Sep 18; Vol. 24 (1), pp. 2533. Date of Electronic Publication: 2024 Sep 18.
DOI: 10.1186/s12889-024-20008-8
Abstrakt: Background: Black men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.
Methods: Clinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa participated in developing a framework for equity in PCA GT grounded in the SEM. A novel mixed-methods approach was employed to generate key areas to be addressed and informed statements for consensus consideration utilizing the modified Delphi model. Statements achieving strong consensus (> =75% agreement) were included in final equity frameworks addressing clinical/community engagement and research engagement.
Results: All societal levels of the SEM (interpersonal, institutional, community, and policy/advocacy) must deliver information about PCA GT to Black males that address benefits/limitations, clinical impact, hereditary cancer implications, with acknowledgment of mistrust (mean scores [MS] 4.57-5.00). Interpersonal strategies for information delivery included engagement of family/friends/peers/Black role models to improve education/awareness and overcome mistrust (MS 4.65-5.00). Institutional strategies included diversifying clinical, research, and educational programs and integrating community liaisons into healthcare institutions (MS 4.57-5.00). Community strategies included partnerships with healthcare institutions and visibility of healthcare providers/researchers at community events (MS 4.65-4.91). Policy/advocacy included improving partnerships between advocacy and healthcare/community organizations while protecting patient benefits (MS 4.57-5.00). Media strategies were endorsed for the first time at every level (MS 4.56-5.00).
Conclusion: The SEM-based equity frameworks proposed provide the first multidisciplinary strategies dedicated to increase engagement of Black males in PCA GT, which are critical to reduce disparities in PCA-mortality through informing tailored screening, targeted therapy, and cascade testing in families.
(© 2024. The Author(s).)
Databáze: MEDLINE
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