Community-based Participatory Research (CBPR) and Campaign on Early Prostate Cancer Screening

prostate health

Integral to a community organization and community building is community-based participatory research (CBPR) that gives researchers the opportunity to identify and address health policy questions at the local level. The theory which is relevant in my campaign for early screening of prostate cancer is ecological system perspective that will focus on the organization and technological forces that could help educate the target population on the management and development of the disease. Globally, cancer is the second leading cause of death, and it is essential for public health oncology to develop interventions to combat mortality and case burden successfully. In addition to the CBPR’s mechanism to increase the ability of health service researchers to impact health by motivating and supporting community partners to participate directly in the research process, and gives academic researchers access to local data. It also enhances interpretation of research findings through understanding of local context, and provides a natural infrastructure for affecting local policy through its community partners. Bridging partnership between academic researchers and community members will help identify the best approach to educate the target population on the potential benefits of early screening. Rimer, Briss, Zeller, Chan & Woolf (2004) stated that considering the complexity of issues regarding prostate cancer screening, experts recommend that men receive support in making informed decisions. This 2004 study of Rimer et al. further noted that competing clinical demands and the challenge of providing sufficient information to support decision making present important barriers to having this decision.

How far can we go to maximize the population’s uptake of screening? Woloshin, Schwartz, Black & Kramer, B. S. (2012) noted that one obvious approach was to use powerful tools of persuasion such as fear, guilt, and a sense of personal responsibility. Vulnerability can be induced by emphasizing the risk of the target population by framing statistics to provoke alarm, and then introduce hope by exaggerating the benefit of the intervention. These said, it is important for public health professionals to stay within the ethical boundary of the information campaign by increasing the awareness of screening’s benefits and risks so as to encourage informed personal decisions. Early prostate cancer screening with prostate-specific antigen (PSA) is controversial because it is not clear whether it reduces mortality and whether the potential benefits of screening and early detection outweigh the risks (Chan et al., 2003). The study added that a public health campaign could begin with a rationale for informed decision making by highlighting that regular prostate cancer screening with PSA may or will not reduce mortality. It is important to develop different strategies for different cultures and educational levels. Increased participation of patients may be required in informed decision making as technology improves in the detection of the disease at an earlier stage. This argument includes public health genomics, and the future of personalized prevention. Pashayan et al. (2013) stated that a risk-tailored screening program should first address the organizational and ethical, legal and social issues and commit to public engagement and education and to work with the health professionals delivering the program.

References

Braddock III, C. H., Edwards, K. A., Hasenberg, N. M., Laidley, T. L., & Levinson, W. (1999). Informed decision making in outpatient practice. JAMA: The Journal of the American Medical Association282(24), 2313-2320.

Chan, E. C., Vernon, S. W., O’Donnell, F. T., Ahn, C., Greisinger, A., & Aga, D. W. (2003). Informed consent for cancer screening with prostate-specific antigen: how well are men getting the message? American Journal of Public Health, 93(5), 779-785.

Glanz, K., Rimer, B., & Viswanath, K. (2008). Health Behavior and Health Education: Theory, Research, and Practice, 4th Edition, 4th Edition. Jossey-Bass, VitalBook.

Hoffman, R. M. (2011). Screening for prostate cancer. New England Journal of Medicine365(21), 2013-2019.

Love, R. R., Ginsburg, O. M., & Coleman, C. N. (2012). Public health oncology: a framework for progress in low-and middle-income countries. Annals of oncology, 23(12), 3040-3045.

O’Brien, M. J., & Whitaker, R. C. (2011). The role of community-based participatory research to inform local health policy: A case study. Journal of general internal medicine26(12), 1498-1501.

Pashayan, N., Hall, A., Chowdhury, S., Dent, T., Pharoah, P. D. P., & Burton, H. (2013). Public health genomics and personalized prevention: lessons from the COGS project. Journal of internal medicine274(5), 451-456.

Rimer, B. K., Briss, P. A., Zeller, P. K., Chan, E. C., & Woolf, S. H. (2004). Informed decision making: what is its role in cancer screening? Cancer, 101(S5), 1214-1228.

Woloshin, S., Schwartz, L. M., Black, W. C., & Kramer, B. S. (2012). Cancer screening campaigns—getting past uninformative persuasion. New England Journal of Medicine367(18), 1677-1679.

 

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