Improving chances of prostate cancer survival in black African men: a study of the information needs of this high-risk group in the UK and S.E. Nigeria.

Research output: Contribution to conferenceAbstract

Abstract

African countries have experienced and continue to face significant health challenges from HIV/AIDS, Cholera and cancers (Anasi 2012), and, more recently, Ebola resulting in high levels of mortality compared to other parts of the world. According to the International Agency for Research on Cancer (IARC, 2012), prostate cancer has the highest mortality rate of all specific cancers in sub-Saharan Africa (18.8%). In 2012, an estimated 30% of all prostate cancer deaths occurred in the least developed countries of the world, and black African men are a high-risk group for the disease (Prostate Cancer UK, 2015). Prostate cancer is treatable if the right information can be communicated to the right people at the right time. Culturally-sensitive information in a format that can be effectively communicated, trusted and used is essential for ensuring the best chance of early detection and survival.

The World Health Organisation (WHO, 2012) defined health literacy as “the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote good health.” It includes empowerment and capacity to access and use information effectively (WHO 2012). Similarly, the Medical Library Association (2015) definition of health information literacy is “the set of abilities needed to: recognize a health information need; identify likely information sources and use them to retrieve relevant information; assess the quality of the information and its applicability to a specific situation; and analyze, understand, and use the information to make good health decisions”. Health (information) literacy goes beyond the ability to read as health information may be delivered in a range of formats and the written format, typically health information pamphlets, may not be the most appropriate means of communication (Finnie et al. 2010). Equally, a literate person may not be health literate when the information is inaccessible. Lack of health (information) literacy has been identified as a key issue for the health of rural Nigerians (Onotai 2013, Olojede et al. 2013) and so it is imperative that this is considered when designing accessible and usable prostate cancer information.

Previous studies of the communication of health information tend to focus on printed or Web-based materials or focused on African-American men (for example, Allen et al. 2007) yet, do not directly examine the information needs and behaviour of the individuals concerned (for example, Atulomah and Atulomah 2012). In Nigeria where 60% of the population is estimated to have low health literacy (Onotai 2013), the incidence of prostate cancer is unusually high in the global context. This research aims to develop a typology of interactions with health information and a set(s) of heuristics for the communication of prostate cancer information based on actual, rather than perceived, needs and behaviour of Nigerian men. It is anticipated that the findings may also be applied to the communication of information about other preventable and treatable diseases in rural communities of African countries.

This paper examines the cultural context for the study, investigates the attitudes and responses to prostate cancer health information by Nigerian men living in the UK and rural Nigeria and analyses the preliminary results from empirical qualitative research and its contribution to meeting the overall aim of the research project.

A case study approach was applied in this research by triangulating qualitative data gathered in informal (semi-structured) one-to-one interviews and focus groups. During the interviews and focus group sessions, the responses and observations of participants to a selection of prostate cancer information in different formats were recorded and transcribed for analysis.

Eighteen Nigerian men took part in the study in the UK in the 4th quarter of 2014. Seven men were interviewed, and groups made up of 5, and 6 men participated in the two focus groups. The participants were recruited from the university and churches in Aberdeen and were literate, educated in English language and aged between 30 and 55 (the ‘at risk’ age group for this type of cancer). They were found to have a little prior awareness of prostate cancer and did not actively seek health care information but demonstrated an interest in the examples of prostate cancer information (leaflet and video) provided by the Nigerian researcher. Analysis of the results of the UK study revealed the attitudes of the UK-based Nigerian participants to information about their health and demonstrated that they valued audio-visual and graphically presented information that can be delivered quickly and provided answers to specific questions. They preferred interpersonal communication of information from trusted sources in their community (peers and church elders) and the traditional medical practitioners.

The Nigerian study was conducted in January and February 2015. The researcher made the journey to rural villages in the South East region of Nigeria (States of Abia, Imo, Enugu and Ebonyi) for fieldwork. A community-based participatory approach was chosen to engage with the rural men (aged 35 years and over and with different levels of literacy) accessed through village leaders (Chiefs). The data collection methods adopted in the UK study were adapted for the Nigerian context and to comply with the requirements of the Chiefs. A less formal approach was taken to the conduct of interviews and focus groups, taking advantage of natural gatherings of men in the community rather than setting up meetings and groups specifically for the research. The research explores the preferred methods of communication and formats for information dissemination and identifies the trusted sources through which prostate cancer information may be disseminated taking account of cultural and religious factors and practical access to available information and communication technologies in rural communities.

By harnessing appropriate channels and formats and developing tools for culturally-sensitive design and creation of prostate cancer information this research aims to contribute to the reduction of prostate cancer mortality in rural Nigeria.
Original languageEnglish
Publication statusPublished - 28 Jun 2017
Externally publishedYes

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