Adoption of Early Intervention Strategies and Providing Education on Prostate Cancer

Integrative Review of Literature
University
NUR702:
04/ 11/ 2021
Integrative Review of Literature
Notably, cancer is one of the most incapacitating causes of burden and death within the United States (US) and the globe, with the illnesses affecting both men and women of all ages (Sadeghi-Gandomani et al., 2017). Early detection of cancer generally has good outcomes, though not all population get the screenings necessary to detect cancer at early stages. One type, prostate cancer is the sixth leading cause of mortality across the world (Sadeghi-Gandomani et al., 2017). In the United States (US), prostate cancer has caused significant health consequences and death among male population and is the most prevalent cancer among males in the African American community when compared to the Whites or other races in the US. Thus it is appears that the African American males are at a higher risk of developing prostate cancer when compared to other races and developing negative symptoms resulting from the disease.
From an observational study conducted at a local clinic on the trend of prostate cancer, it is evident that more than half of the black males diagnosed with prostate cancer tend to be in their fifties, years beyond the risk range for screening. As such, the clinical problem is the noticeable disparity in the incidence and screening for prostate cancer in the black community. Early detection could have a significant impact on both patient outcomes and the healthcare system if the problem is addressed (Ilic et al., 2018). Generally, cancer can be more effectively treated and managed if it is addressed while still in the early stages. It is important to address the lack of screening for prostate cancer in African American males. This paper seeks to review the literature to determine if provision of early education to African American men on prostate cancer would increase their knowledge/awareness of the need for early detection of prostate cancer and significantly increase screening for the disease.
Literature Search Methods
The literature search methods involve a combination of many strategies that enables the researcher to explore multiple search engines and identify research articles with significant content related to the project’s clinical problem. Some of the tactics involved in the literature search include sampling strategies, as well as inclusion and exclusion criteria. There is an enormous amount of published data online that provides information on numerous topics. Using different search engines and databases, and keywords specific to the chosen topic helped to identify appropriate literature that supported the evidence-based practice change project. In this section an exploration of the sampling strategies, inclusion and exclusion criteria, and an analysis of the strengths of the research studies included is discussed.
Sampling Strategies
Most of the research articles reviewed and analyzed used purposive sampling techniques, whereby clients included African American men with the focus of early education regarding prostate cancer and the importance of early screening. One of the databases that I used during the search is Education Resources Information Center (ERIC) using the key words: African American men and knowledge of prostate cancer and prostate cancer screening. I also searched for research studies from Google Scholar using the keywords African American men and knowledge of prostate cancer and prostate cancer screening. During the search in the two databases, I filtered the results to a 10-year period range and peer-reviewed articles.
Inclusion/Exclusion Criteria
The review utilized inclusion/exclusion criteria to identify the research studies that were relevant to the research question. Specifically, the variables of the research question played a crucial role in guiding the selection of the studies during the review process. The inclusion criteria provided for all the studies that were focused on prostate cancer and concentrated on the African Americans. The exclusion criterion included elimination of all research studies done outside the United States and old research beyond the date range. Notably, the inclusion/exclusion criteria ensured that the specifics of each study fit the research question under review.
The strength of the studies incorporated in this literature review was enhanced by selection and utilization of high levels of evidence studies. Notably, most of the studies incorporated were levels IV, level, and level VI evidence research studies that were obtained from, well-designed case-control or cohort studies, systematic reviews of descriptive and qualitative studies (meta-synthesis), and single descriptive or qualitative study. The reliability of and the validity of the research studies included were also considered while potentially biased studies were not utilized in the review.
Literature Review Findings
This section will provide a review of the studies identified from the literature search. First, general findings from the review process will be discussed. Then the studies that supported the chosen intervention will be shared in more detail.
General Findings
According to research by Basch et al. (2012), men with longer life expectancy may benefit from PSA testing. The study further identified that adverse events linked to prostate biopsy are low for most men, although several population-based studies have shown increasing rates of infectious complications after prostate biopsy. Nonetheless, the study indicated that general screening for prostate cancer with total PSA for men with a life expectancy of 10 years and below be discouraged as harm seems to outweigh the potential benefits. However, I did not include the results of the study in the intervention section as the study did not review African American men within the age range, but instead concluded about men with longer life expectancy.
Another study by Illic et al. (2018) found that screening had no effect on all-cause mortality as well as prostate specific mortality. However, the authors of the study estimated that for every 1000 men screened, approximately 1, 3, and 25 more men would be hospitalized for sepsis, require pads for urinary incontinence, and report erectile dysfunction, respectively. The authors of the study did not report if the benefits associated with PSA testing for prostate cancer screening were worth the harm associated with screening and subsequent unnecessary treatment. I did not use this study to support the chosen intervention; as it did not provide any evidence of the benefit/risk of PSA screening on diverse populations, specifically African Americans the population of interest for this literature review.
Raising awareness about prostate screening helps to promote early detection of prostate and informed-decision making. In the initial stages, prostate cancer is curable and screening is one of the interventions to improve the quality of life and reduce the risk of complications. Furthermore, screening is incorporated in interventions to establish effective treatments and diagnosis. Patients who lack knowledge on PCa are less likely to make informed decisions about screening. On the other hand, culturally appropriate interventions would enhance patient education and support informed decision-making (Gökce et al, 2016). Identifying barriers to screenings is necessary to improve cancer screening and management, which in turn, helps to improve health outcomes. Targeted interventions, including prostate cancer screening and education, may positively change behavior and attitudes among African American men.
Chosen Intervention
According to research by Dean et al. (2015), black men were significantly unlikely to utilize early screening tools such as the prostate-specific antigen (PSA) testing for prostate cancer. The study decided to investigate the social factors that might be associated with PSA testing avoidance. They wanted to identify what might promote screening behaviors for prostate cancer and other health conditions for which Black men are at high risk. The authors found that social interactions and spirit of neighborhood may play a role in screening behaviors among Black men. Attracting patients to attract patients from undeserved communities to screening and patient education sessions such as African Americans would have a positive influence on health beliefs and behavior. The authors recognized the African American adults could respond better to health education and screening information through their church and other community organizations for social connections and support.
Community-based cancer screenings targeting high-risk groups and underserved communities are effective in improving cancer screening behaviors and follow-ups (Ashorobi et al., 2016). Effective educational tools are necessary to improve knowledge on PSa screening among the targeted male participants. The research by Ashorobi et al. (2016) focuses on African American men (AA) who are disproportionately affected by PCa, and the research is relevant to evaluate the effectiveness of Prostate Outreach Project (POP). PCa education, screening, and testing improve the level of knowledge on PCa, and the lack of knowledge on PCa is one of the reasons for low participation in PCa screening.
A study by Luque, Ross and Gwede (2016) was conducted with the aim of determining if the provision of education to African American men on prostate cancer in the barbershop setting would increase their knowledge and awareness on the need of early detection of prostate cancer through screening for the disease. The authors found a difference between participants in the intervention arm who had marginally higher level of PCa knowledge (p = .05). Fifty-two (43%) participants had received a PSA test in their lifetime. The authors of this study found that the involvement of the barbershops as health promotion settings was effective in promoting prostate cancer (PCa) screening among African American men.
Patel et al. (2012) study was proposed to assess the impact of an educational intervention on prostate cancer screening behavior and knowledge. The study included 104 African American men, 45 years and older, who had not been screened for prostate cancer within the past year.
The results of the study identified that it was feasible and efficacious for an academic institution to collaborate with an African American community to develop a successful prostate cancer education intervention approach in increasing knowledge and screening habits. The researchers highlighted there was increased knowledge on prostate cancer screening and reduced and barriers to screening among t those who were screened compared to those who were not screened.
According to Gökce et al. (2016), the American Cancer Society (ACS) Decision Aid (DA) (ACS-DA) is effective in increasing knowledge on PCa among underserved African American men and is associated with greater support for PCa screening. Decision aid tools are developed to educate patients, and open discussion is necessary to support patient education programs and interventions. Using Decision Aid (DA) tools for screening and managing prostate cancer in medically underserved men improves health outcomes and knowledge in such populations that are often under-educated (Gökce et al., 2016). The focus on patient education and knowledge is also associated with reduced decisional conflict, and patients need to be informed about the benefits of screening and early detection. Gökce et al. (2016) reported a statistically significant increase in the share of men with adequate PCa knowledge after the participants received ACS-DA.
As such, these studies were supportive on the benefit of adoption of early intervention measures such as the provision of early education to African American men on prostate cancer. They were also conclusive on the effectiveness of screening tools such as PSA as it increased their PCa knowledge and screening habits that are necessary in the adoption of early treatment interventions geared towards promoting the quality of life of the clients.
Discussion
In the discussion section, a general discussion on the literature review is done by analyzing the findings, and the conclusions derived from the research studies explored. Additionally, this section also presents the limitations of the research studies utilized herein, while drawing on the conclusion of the findings by the different authors of the research studies utilized. Nonetheless, this section also explores the potential practice change based on the findings of the literature review exploration.
From the studies reviewed, it was determined that the provision of education on prostate cancer and the effectiveness of utilizing screening tools such as PSA were effective in increasing knowledge and awareness on PCa and significantly increases screening habits. The study by Patel et al. (2012), affirmed the provision of education as it showed that the knowledge score increased and barriers to screening decreased upon provision of education on prostate cancer among the target population. Additionally, the study by Luque, Rossand Gwede (2016), also affirmed this as it found that the involvement of the barbershops as health promotion settings would be effective in promoting PCa screening among African American men. As such, the provision of early education to African American men could be significant ...