Feasibility of Disseminating a Prostate Cancer Peer Education Intervention in the Community

Background and Purpose: In 2019 approximately 175,000 diagnoses and 32,000 deaths were attributed to prostate cancer (PC). PC is the most common cancer and leading cause of cancer-related death among men in the United States. Black men, compared to any other race, are more likely to be diagnosed with PC and are also more than twice as likely to die of prostate cancer compared to White men. In Philadelphia, the incidence and mortality rates exceed national averages, and rates are highest among Black men. Based on a previously developed educational intervention to improve knowledge and promote informed decision making about prostate cancer screening, we aimed to determine the feasibility of implementing an educational program about prostate cancer in community settings and to measure changes in men’s knowledge and attitudes about prostate cancer.

Methods: Men were recruited through community organizations, email lists, online postings on Facebook and Craigslist. Inclusion criteria include men between the ages of 40-69 who lived in one of the five Southeastern counties; had not been diagnosed with prostate cancer or screened for prostate cancer within two years. Peer educators were trained to deliver the PC educational intervention. They talked with men about prostate cancer risk factors, prostate biology, screening techniques, and decision making. Men completed a baseline, post, and one-month post-session survey with validated tools to assess their PC knowledge, prostate discussion and screening intentions, and perceived understanding of PC screening. Descriptive statistics summarized participants’ characteristics. A two-way repeated measures ANOVA was conducted using data from participants who completed all three surveys. This analysis assessed within-subject changes in knowledge, screening intentions, and perceived understanding across three time points (pre-session, post-session, and one-month follow-up) and tested for interaction effects by age group and education level.

Results: Between March 2021 and February 22, 86 men were recruited and participated in 8 virtual sessions. Twenty-eight men were lost to follow-up, resulting in a total of 58 who completed all three surveys. Analyses were limited to these completers. The men ranged in age between 40-69 years with a mean age of 55. The sample was 54% Black/African American, 40% White, and 5% Hispanic/Latino or other. Regarding education, 54% had some college or an associate degree or less, and 46% held a college degree or higher. Significant within-subject improvements were observed between pre- and post-session in knowledge (F=7.63, p<.01), screening intentions (F=11.98, p<.001), and perceived understanding (F=58.26, p<.001). These improvements were sustained at the one-month follow-up, with no significant decline. No significant interaction effects were found by age group or education level, indicating that the intervention was effective across all subgroups.

Conclusions and Implications: The educational intervention was feasible and effective in improving men’s knowledge, screening intentions, and perceived understanding of screening, with sustained effects at one-month follow-up across all age and education groups. These findings support the value of peer-led approaches in promoting informed decision-making, particularly in high-risk populations.