African Americans and Prostate Cancer: Raising Awareness in Barber Shops

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When you look at the statistics regarding African Americans and prostate cancer, the numbers are disturbing. Black men are more likely to develop prostate cancer and twice as likely to die from the disease. According to the American Cancer Society, an estimated 30,000 African American men were given a diagnosis of prostate cancer in 2016, and more than 4,400 black men are believed to have died of the disease that year.

Because men in general, and black men in particular, are notoriously lax about seeking preventive health measures, some initiatives across the country have turned to an innovative way to raise awareness of the disease and other health issues that are common among men.

What are these initiatives doing to get their message out? They are visiting barber shops and engaging black men in conversations—and screenings—about their health.

The Black Barbershop Health Initiative

In April 2019, for the ninth year in a row, the Black Barbershop Health Initiative held health screening events across the state of Indiana. Those events didn’t take place in clinics or hospitals but at 10 establishments where black men routinely gather to get their hair but and to socialize. The Indiana Commission on the Social Status of Black Males created this annual community event to help fill a gaping hole in preventive health care for African American men.

According to Esther Lewis, a local organizer of The Black Barbershop Health Initiative, although black men are not good about visiting a doctor, “they do go to the barber shop every other week and get their hair cut. We wanted to pair those together.” Volunteer health professionals, including doctors, nurses, and nursing students, were available at the barber shops to provide free blood pressure tests, blood glucose tests, weight and body mass index evaluations.

The Initiative chose prostate cancer as their focus in 2019, and all men could get a prostate-specific antigen (PSA) test, a prostate exam, and information about prostate health and prostate cancer when they visited one of the participating barbershops. They also could get information about how to stop smoking, vaccinations, nutrition, and other age-appropriate health care for men.

Other barber shop men’s health initiatives

Indiana is not the only state or venue for barber shop men’s health initiatives. About a decade ago, Dr. Bill Releford developed the Black Barbershop Health Outreach Program (BBHOP) in Los Angeles. It is a national program designed to engage African American men in screenings, education, and other health-related activities in a setting where they feel safe and comfortable. Many of the screenings done are for high blood pressure and diabetes, both of which are especially rampant among African Americans.

In Toledo, Ohio, at least half a dozen barber shops have started health screenings in their shops. Medical professionals help patrons with tests for high blood pressure and diabetes, teach CPR, hand out home cancer screenings, and encourage men to get PSA screenings. The initiative started in 2017 and now makes twice monthly visits to the shops.

Here’s another way barber shops are playing a role in helping African American men beat prostate cancer. Recruitment for a multi-institutional study, called Research on Prostate Cancer in Men of African Ancestry: Defining the Roles of Genetics, Tumor Markers, and Social Stress (RESPOND) began in January 2019. The study is funded by the National Cancer Institute, the Prostate Cancer Foundation, and the National Institute on Minority Health and Health Disparities.

RESPOND researchers will target the effect of social stressors (e.g., education, early life events, socioeconomic status, home life) as well as biological and genetic factors on the development and progression of prostate cancer in black men. They also will try to uncover why African American men are at greater risk for developing the more aggressive forms of prostate cancer and why death rates are higher. Where will the researchers be looking for participants in the study? Barber shops.

Is handing out information on prostate cancer effective?

Offering men free PSA testing at a barber shop is one approach to raising awareness of prostate cancer, but is just handing out information enough? In a study appearing in the Journal of Cancer Education, investigators evaluated the effectiveness of providing decision support instruments (DSIs) to African Americans in barber shops to help them make a decision about prostate cancer screening. The study assessed two different DSIs—one that was culturally specific for the population and one that was not.

A total of 120 men aged 40 years and older participated in the study. The men were given the information and followed up three months later to see if they had gone for prostate cancer screening and their knowledge about such screening. The authors found that:

  • The level of knowledge about prostate cancer screening was the same regardless of which type of DSI the men received
  • Similar proportions of men said they intended to go for a PSA test regardless of which information they received. However, the mens’ degree of certainty regarding screening increased among those with the culturally tailored information.
  • At the three-month follow-up, half (58) of the men had undergone PSA testing, and one man was found to have prostate cancer

The authors concluded that “barbershop-based health education can change the knowledge, preferences, intentions, and behaviors of this at-risk population.”

African Americans and prostate cancer

Not only are African American men more likely to develop prostate cancer than white men; they also tend to get the disease at a younger age. However, this population also is largely undiagnosed until the cancer is at a more advanced stage and men tend to have a more severe type of the disease. All of these factors make it especially critical for African American men to take part in health screenings and engage with the medical community on a regular basis. Barber shops may help play an important role in moving this effort forward.


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