Prostate Cancer and Afro-Caribbean Men

236 Pages·2015·1.52 MB·English

Walden University
ScholarWorks
Walden Dissertations and Doctoral Studies
Walden Dissertations and Doctoral Studies
Collection
2015
Prostate Cancer and Afro-Caribbean Men:
Experiences, Perceptions, and Beliefs
Harold Evelyn Taitt
Walden University
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Walden University

College of Health Sciences

This is to certify that the doctoral dissertation by

Harold Taitt

has been found to be complete and satisfactory in all respects,
and that any and all revisions required by
the review committee have been made.

Review Committee
Dr. Robert Hoye, Committee Chairperson, Health Services Faculty
Dr. James Goes, Committee Member, Health Services Faculty
Dr. Vincent Agboto, University Reviewer, Health Services Faculty

Chief Academic Officer
Eric Riedel, Ph.D.

Walden University
2015
Abstract
Prostate Cancer and Afro-Caribbean Men:
Experiences, Perceptions, and Beliefs
by
Harold E. Taitt

MBA, Carlson School of Management, University of Minnesota, 1990
Graduate Certificate, Health Services Management, DeVry University, 2010
B.S., University of Minnesota, 1989

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Services

Walden University
May 2015
Abstract
Despite the high incidence of prostate cancer (PC) amongst men of African descent, there
is a paucity of qualitative data that explores how Afro-Caribbean men perceive their risk,
susceptibility to, and management of this disease. This phenomenological study sought
to explore and analyze beliefs about PC in a sample of Afro-Caribbean men who reside in
the United States (U.S.). The research questions considered the perceptions, beliefs, and
lived experiences of participants. The conceptual framework is a synthesis of the health
belief model (HBM) and the theory of reasoned action (TRA), primarily because the
TRA allows for a culturally-based relevance and perspective that is lacking in the HBM.
Data were collected using in-depth interviews from a purposive sample of 13 U.S.
participants from 7 Caribbean territories, who provided detailed descriptions of their
perceptions. Data management and inductive, iterative analysis were facilitated through
the use of the NVivo 10 software program. This study found that participants had a low
level of awareness and education about PC, but they also believed that if PC were caught
early, they have a good chance of a long life. There was no indication that culture played
a significant role in their attitudes, beliefs, and perceptions of the disease. Education
about PC should be targeted to this population as well as their significant others. In
addition, qualitative research is needed to compare perspectives of Afro-Caribbean,
African American, and African men who all reside in the United States. This study may
contribute to positive social change by providing practical strategies that may increase
screening and early diagnosis among Afro-Caribbean men, thereby reducing the mortality
from this disease.
Prostate Cancer and Afro-Caribbean Men:
Experiences, Perceptions, and Beliefs
by
Harold E. Taitt

MBA, Carlson School of Management, University of Minnesota, 1990
Graduate Certificate, Health Services Management, DeVry University, 2010
B.S., University of Minnesota, 1989

Dissertation Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Philosophy
Health Services

Walden University
May 2015
Dedication
To my dad Harold Taitt Senior, who is 91 and has been an inspiration to persevere
and achieve all that I can. His love of God, his concern for family, and the stories he
shares about his travels and experiences during World War II have never ceased to
intrigue and fascinate me. Despite having to leave school at the tender age of 12, he
obtained his Doctor of Philosophy in Religion later in life and became an ordained
minister. My dad also has a history of prostate issues and that was a partial reason why I
chose a topic relating to prostate cancer. I also dedicate this accomplishment to my
daughter Nyoka Taitt, whose confidence and desire to succeed will take her wherever she
chooses to go in this life.
Acknowledgments
I want to acknowledge and thank Dr. Robert Hoye, who has been my mentor for
the duration of my studies at Walden University and the chair of my dissertation
committee. Dr. Hoye has been a tremendous source of encouragement and has been
willing to communicate with me at a moment’s notice, especially during those times
when I needed to deal with family issues and felt discouraged during my journey. To my
other committee member, Dr. Jim Goes, who took the time to ensure that my efforts were
consistent with the high standards that Walden University is known for. To my
Knowledge Area Module assessors, Dr. Hoye, Dr. Goes, and Dr. Jeanne Connors, I thank
you for your patience and encouragement, and the high level of excellence you
consistently demanded.
To my colleagues in our research forum, thank you for the comments, ideas, and
suggestions we shared over my 4 years at Walden. To my brother Colin, who was always
available when I had computer issues. Finally, many thanks to my friend Cynthia
Abdulla, who patiently spent many hours editing this paper and transcribing the data from
my research, as well as encouraging me throughout this journey.
Table of Contents
List of Tables ................................................................................................................... viii
List of Figures .................................................................................................................... ix
Chapter 1: Introduction to the Study ....................................................................................1
Background ....................................................................................................................3
History of the Caribbean Region .............................................................................3
Afro-Caribbean men, African American Men and Prostate Cancer ........................4
Problem Statement .........................................................................................................7
Purpose of the Study ......................................................................................................9
Research Questions ......................................................................................................10
Conceptual Framework ................................................................................................10
The Health Belief Model .......................................................................................11
The Theory of Reasoned Action ............................................................................12
Nature of the Study ......................................................................................................14
Definition of Terms......................................................................................................15
Assumptions .................................................................................................................17
Scope ............................................................................................................................18
Delimitations ................................................................................................................18
Limitations ...................................................................................................................19
Threats to Validity .......................................................................................................21
Internal Validity (Credibility) ................................................................................21
External Validity (Transferability) ........................................................................23
i
Significance of the Study .............................................................................................24
Implications for Further Research ...............................................................................25
Implications for Social Change ....................................................................................26
Summary ......................................................................................................................27
Transition Statement ....................................................................................................28
Chapter 2: Literature Review .............................................................................................30
Literature Search Strategy............................................................................................33
Conceptual Framework ................................................................................................35
The Health Belief Model .......................................................................................35
Theory of Reasoned Action ...................................................................................39
Combining HBM and TRA ....................................................................................40
Cultural Phenomena Affecting Health .........................................................................41
Literature Review Related to Key Variables and Concepts.........................................43
Etiology of Prostate Cancer ...................................................................................43
Signs and Symptoms of Prostate Cancer ...............................................................44
Prevention Strategies .............................................................................................44
Risk Factors ...........................................................................................................45
Prostate Specific Antigen (PSA) ............................................................................50
Global Patterns and Prostate Cancer ............................................................................51
Dynamics of Prostate Cancer in African-American Men ............................................55
Prostate Cancer Information and African-American Males ..................................56
Awareness of Prostate Cancer among African American Men .............................57
ii
Early Detection in African-American Men............................................................58
Perceptions of Prostate Cancer amongst African-American Men .........................61
Prostate Cancer and Native African Men ....................................................................62
Prostate Cancer Incidence in African Countries ....................................................63
Early Detection in Native African Men .................................................................66
Prostate Cancer and Black men in the United Kingdom .............................................67
History and immigration patterns of Black men to the United Kingdom ..............67
Prostate Cancer Incidence Rates in the United Kingdom ......................................68
Perceptions of Prostate Cancer amongst Black Men in the United Kingdom .......71
Prostate Cancer and Afro-Caribbean Men ...................................................................72
History of Afro-Caribbean Migration to the United States ...................................72
Prostate Cancer Incidence Rates and Afro-Caribbean Men ..................................73
Qualitative Studies of Prostate Cancer and Afro-Caribbean Men .........................76
Early Detection in Afro-Caribbean Men................................................................78
Perceptions of Prostate Cancer amongst Afro-Caribbean Men .............................79
Prostate Cancer and Other Races and Ethnicities ........................................................81
Literature Review Related to Research Methodology .................................................83
Qualitative Designs ................................................................................................83
Reasons for Using Open-ended Interviews............................................................87
Data Saturation and Phenomenology. ....................................................................88
Summary ......................................................................................................................88
Conclusion ...................................................................................................................92
iii