Addressing Rural African American Prostate Cancer Survivorship through Spirituality: A Qualitative Study

Background and Purpose:The purpose of this pilot study was to explore the role of spirituality as a form of treatment adherence and coping among 10 rural African American prostate cancer survivors (RAA-PrCA), age 50+years with localized PrCA (Stage 1-2) who are at least 6 months post diagnosis who identify as spiritual.

Rationale:What we know about prostate cancer survivorship among African Americans is largely derived from clinical trials with poor African American representation and participation (Ahaghotu, Tyler & Sartor, 2016). The existing literature on African American prostate cancer survivorship fails to address the social, psychological, spiritual, and economic sequelae of this disease among rural populations. For instance, there are a large number of published studies (e.g., Holt et al. 2009c; Holt et al. 2009d; Holt et al., 2015) which demonstrate that spiritually based PrCA interventions positively intersected within the context of an all-male group composed of church affiliated African American men; therefore, this pilot study explored the influence of the psychosocial-spiritual distress within the context of their intersecting identities as rural African American prostate survivors.

Method:Each in-depth semi-structured interview reflected upon the two theoretical frameworks Critical Race Theory (CRT) and Collin’s (2015) Theory of Intersectionality (TOI) as a means to better contextualize the psychosocial-spiritual factors of PrCA survivorship and unexpressed processes that influence survivorship among RAA-PrCA survivors. Using Polkinghorne’s (1995) narrative analysis and analysis of narrative this study used purposive sampling to recruit participants through churches cancer clinics, academics, barbershops, word-of-mouth, and health fairs.

Findings:Data analysis revealed the following emerging themes: masculinity, lack of knowledge, advocacy, the importance of prayer, early screening, and support from family, friends, and significant others (e.g., spouses). Each of these themes were coded through the method of In Vivo coding (Saldaña, 2015)which privileged “the direct language of participants as codes rather instead of the researcher- generated words and phrases” (p. 71).

Conclusions and Implications:Given the multi-faceted ways in which PrCA survivorship affects the quality of life and may influence re-occurrence among RAA-PrCA survivors; for these reasons, the findings of this study can provide social work practitioners and educators insight into why it is vital we problematize the racial disaggregation of rural African PrCA survivorship from the cancer disparity discourse centered around psychosocial-spiritual factors and post-treatment issues. More importantly, better understand the role of spiritual practices (e.g., prayer, church-based support groups) in conjunction with other conventional health care practices related to PrCA survivorship among African-Americans in rural areas.