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Fear, Knowledge, and Efficacy Beliefs Differentially Predict the Frequency of Digital Rectal Examination Versus Prostate Specific Antigen Screening in Ethnically Diverse Samples of Older Men

Psychology Department, Long Island University, Brooklyn, New York, nconsedi{at}liu.edu

David Horton

Intercultural Institute on Human Development & Aging, Long Island University, Brooklyn, New York

Tracey Ungar, PhD

Intercultural Institute on Human Development & Aging, Long Island University, Brooklyn, New York

Andrew K. Joe, MD

Mailman School of Public Health, Columbia University, New York, New York

Paul Ramirez, PhD

Psychology Department, Long Island University, Brooklyn, New York

Luisa Borrell, PhD

Mailman School of Public Health, Columbia University, New York, New York

Emotional and cognitive characteristics have been studied in the context of women’s cancer screening but have received scant attention in the study of men’s screening behavior. Researchers know little about how such factors interact to predict screening or whether digital rectal examination (DRE) and prostate specific antigen (PSA) screens are predicted by the same characteristics. This study examines the relevance of emotional and cognitive characteristics to DRE and PSA screening among 180 U.S.-born African American, U.S.- born European American, and immigrant Jamaican men. The study identifies the expected effects in which fear is negatively related and efficacy beliefs positively related to DRE and PSA screening. Greater efficacy and (marginally) knowledge appear to "offset" the negative impact of fear on screening, and fear appears particularly relevant to DRE frequency. Results are discussed in terms of their implications for the development of health belief and self-regulatory models in the context of prostate cancer screening among minority men.

Key Words: prostate cancer • cancer screening • health belief model • ethnic subpopulations • African American • Jamaican • fear • efficacy • knowledge • Caribbean

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