Abstract

Prostate cancer(PCa) is the leading non-cutaneous cancer in men worldwide. Black men are disproportionately affected with a risk of 1 in 4 where they tend to develop PCa younger than most men, are diagnosed with a more aggressive disease, are more likely to advance to a higher metastatic state, and die at a higher rate than any other ethnic group. Age appropriate screening via the prostate-specific antigen test and digital rectal examination is critical and standard clinical practice, however, Black men have the lowest engagement in timely preventative health screenings and medical treatment. African-born immigrants are one of the fastest growing immigrant groups in the U.S. yet there has been limited research on African immigrant health and even less on cancer research. Current standard of practice involves aggregating all Black subgroups into one large group of “Black/African American” without assessing any sub-groups despite cultural differences between African American, Afro-Caribbeans, and sub- Saharan African immigrants. Thus, the purpose of this study was: 1) to assess African immigrant men health profile, 2) to understand the knowledge, attitudes and perceptions of PCa among African immigrants (compared to African Americans and Caribbean immigrants) and, 3) to assess the role psychosocial factors/stressors play with respect to PCa screening behavior and intentions among African men, compared to African American and Caribbean immigrants? A concurrent mixed-methods study design was employed with focus groups (n=51) and key informant interviews (n=10), along with a cross-sectional study using convenience sampling was conducted with Black men(African Americans (n=271), Caribbean Blacks (n=203), and African immigrants (n=95)) recruited from across the United states. Results revealed that African immigrant health and perspectives are unique given that their identity is divided into 3 facets, being an African male, an immigrant and a Black male in America. Black men are not a monolithic group for differences exist in PCa knowledge, perceptions of screening, medical mistrust, discrimination, financial strain, perceived stress and social support. The results of this dissertation reveal that it indeed does matter whether a Black man is African American, Caribbean immigrant or an African immigrant when addressing PCa health disparities and the factors that influence it.

LLU Discipline

Social Policy and Social Research

Department

Social Policy and Research

School

School of Behavioral Health

First Advisor

Susanne B. Montgomery

Second Advisor

Lisa Roberts

Third Advisor

Qais Alemi

Degree Name

Doctor of Philosophy (PhD)

Degree Level

Ph.D.

Year Degree Awarded

2021

Date (Title Page)

3-2021

Language

English

Library of Congress/MESH Subject Headings

Prostate cancer; African immigrants; Medical screening; Health disparities; Psychosocial factors

Type

Dissertation

Page Count

xv, 212 pg.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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