Barbers Become Lay Prostate Cancer Educators

Stephanie Doyle

May 19, 2008

May 19, 2008 (Orlando, Florida) — Barbers are learning to educate their clients — mostly African American men older than 40 years — about the importance of prostate cancer screening and are doing so successfully, according to research findings presented here at the Cancer, Culture & Literacy: 6th Biennial Conference.

"I would love to see this venue maximized to the fullest to educate men,'' Brian Rivers, PhD, assistant professor of health outcomes and behavior at H. Lee Moffitt Cancer Center & Research Institute, in Tampa, Florida, told Medscape Oncology. "The idea would be to have a statewide or even a nationwide barbershop initiative — and not just for prostate cancer but for other diseases that adversely impact men."

Rivers pointed out that prostate cancer is the second leading cause of cancer death for men in the United States and that African American men have the highest incidence rate for prostate cancer in the United States and are more than twice as likely as white men to die of the disease.

Barbers Against Prostate Cancer is a 1-year joint research project by Moffitt Cancer Center, the Tampa Bay Community Cancer Network, and the Community Health Advocacy Partnership.

Because of the sensitivity of prostate-screening tests, researchers wanted to explore whether community-based efforts by the lay public, specifically barbers, that involved education and prevention messages could help bridge the communication divide and increase screenings among African American men.

They used a mixed-methods approach to evaluate the achievability of training barbers as lay health educators on the topic of informed decision-making with prostate cancer screening. The training piece of the educational intervention was based on the principles of Freire's critical pedagogy. The survey was designed to elicit cultural domains to understand beliefs about prostate cancer among African American men over the age of 40 years.

Eight barbers in the Tampa area underwent 10 hours of training during a 4-week period before beginning the 2-month educational intervention. In-depth interviews were conducted with the barbers, as were structured interviews with 40 of the barbers' clients to gauge behavioral intention to discuss prostate cancer with a healthcare provider after receiving educational information from the barbers. Barbershop clients also were interviewed about their prostate screening intentions and knowledge of prostate cancer.

Pretests and posttests were conducted. Results showed a significant increase in barbers' knowledge of prostate cancer (z = -2.32; < .05). Qualitative data based on the in-depth interviews with the barbers and process-evaluation data suggest that educating barbers and then having them communicate that information to the African American community is a practicable approach. A small number (n = 15) of barbershop clients were surveyed after the intervention. The clients shared the belief that a prostate cancer diagnosis was related to not getting the exam and to food and dietary factors.

The pilot study is ongoing, with barbers asking their male clients over the age of 40 years if they have ever been screened for prostate cancer. A client who responds negatively is educated about prostate cancer and made aware that he is a candidate for prostate cancer screening. Rivers hopes the initiative will continue when the pilot-study funding ends.

"We get stuck in our scientific meetings and journals and the information doesn't get to the lay public,'' Rivers said. "The hope is to decentralize the information and take it out of the clinical setting."

Jim Wallace, a volunteer with the Florida Prostate Cancer Network since 1995, said he hopes additional cities — especially those with no similar community-based initiative — will adopt a BarbersAgainst Prostate Cancer project. He also hopes the project will include prostate cancer screenings for the barbers. Health fairs, he said, are often held on Saturdays — a barbershop's business day.

"You all have helped us, now we're going to do something for you," said Wallace, who was not involved with the study.

Funding was provided by the National Cancer Institute. Dr. Rivers disclosed no relevant financial relationships.

Cancer, Culture & Literacy: 6th Biennial Conference: Abstract 17. Presented May 16, 2008.

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