A comprehensive, mixed methods assessment of African-American men's and women's health and cancer decision making

African Americans (AAs) are more likely to develop and die from cancer than any other racial or ethnic group. Numerous factors serve as barriers to informed health decision making (e.g., cancer screenings) among AAs. Given this cancer disparity, the purpose of this study was to use a mixed methods approach to assess AA men's and women's (1) knowledge and attitudes regarding prostate cancer prevention and screening, (2) health and cancer-related decision making practices, and (3) perceived impact of a community photovoice experience and booklet. Data were collected from a total of 81 participants using qualitative focus groups (81 participants), quantitative pre/post survey data from a community education program, (56 of 81 participants), and a photovoice experience (15 of 81 participants). All data were collected in South Carolina. Focus group findings showed that men often relied on their female significant other and doctors for health-related information and decisions. In line with men's decision making, women described their role and responsibility as assisting with their male partners' health and cancer-related decisions. AA men's and women's prostate knowledge scores increased significantly between pre- and post-tests. Finally, most of the photovoice participants reported that the experience and booklet had influenced a change in their dietary behaviors and health decision making. Future community-based formative research and intervention work should consider using a similar mixed methods approach to explore a more complete picture of health- and cancer-related decision making in AA communities.