Analyzing Factors Enabling Prostate Cancer Screening Behaviors Among African American Males in the South Region Using the Andersen's Behavioral Model of Healthcare Services Utilization.

Youseung Kim, Mustapha Alhassan
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Abstract

Prostate cancer is the second leading cause of cancer death among men in the United States, and African American men especially represent a high risk population for prostate cancer. Although the overall prostate cancer incidence rates have been declining since 1992, the average annual prostate cancer incidence rates among African American men were still higher than any other racial groups, and the mortality rates were 2.1 times higher than that of Caucasian men. This study examined what factors including cultural mistrust were related with the prostate cancer screening behaviors among African American males in the South East region. Out of 496 prostate educational seminar attendees, 304 volunteers completed the survey about the behaviors of prostate cancer, cultural mistrust for health providers and general health beliefs and health behaviors. Using Anderson's Behavioral Model of Health Services Use, hierarchical multivariate logistic regression analysis was conducted to identify which predisposing, enabling, and need factors could predict prostate cancer screening behaviors and whether there was any interaction effects among these predictors. Findings revealed that annual household income and annual health check-up were significantly related with the prostate cancer screening behaviors while the effect of health insurance was diminished among older African American males. Overall, results highlight the importance of financial resources as a determinant of prostate cancer screening behaviors among African American males implying the need of substantial support to overcome the obstacles from financial adversity.

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利用Andersen的医疗服务利用行为模型分析南方地区非裔美国男性前列腺癌筛查行为的影响因素
前列腺癌是美国男性癌症死亡的第二大原因,非裔美国男性尤其代表了前列腺癌的高风险人群。尽管自1992年以来,前列腺癌的总体发病率一直在下降,但非洲裔美国人男性的前列腺癌年平均发病率仍高于其他任何种族群体,死亡率是白种人男性的2.1倍。本研究考察了包括文化不信任在内的哪些因素与东南地区非裔美国男性前列腺癌筛查行为有关。在496名前列腺教育研讨会的参与者中,304名志愿者完成了关于前列腺癌行为、对医疗服务提供者的文化不信任以及一般健康信念和健康行为的调查。采用Anderson的健康服务使用行为模型,进行分层多元逻辑回归分析,以确定哪些易感因素、使能因素和需求因素可以预测前列腺癌筛查行为,以及这些预测因素之间是否存在相互作用。研究发现,家庭年收入和年度健康检查与前列腺癌筛查行为显著相关,健康保险的影响在老年非裔美国男性中减弱。总的来说,研究结果强调了经济资源作为非裔美国男性前列腺癌筛查行为的决定因素的重要性,这意味着需要大量的支持来克服经济逆境的障碍。
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