Abstract A55: Assessing the applicability of leventhal's common sense model of illness representation to explain african american prostate cancer survivors' disease experiences and disease Management Strategies
Authors: Johnson Jarrett , Pandeya Sarbesh , Kabore Ahmed , Ross Levi 
Published: March 2017

Background: Culture has a major influence on many aspects of health in general, and cancer prevention and control in particular. Culture influences the receptiveness of consensus and evidence-based risk reduction strategies across the continuum of care. Culture also provides men with templates for interacting with clinicians and the health care system. Over the past two decades, medical and public health practitioners have devoted a great deal of attention to understanding how African American culture influences the multi-level processes that create or maintain prostate cancer treatment disparities. The current study adds to this growing body of literature by exploring the usefulness of Leventhal's Common Sense Model (CSM) of Illness Representation to explain the content and structure of African American prostate cancer survivors' narratives of their disease process and disease management strategies. Narrative structure was evaluated using the five illness representation domains of the CSM (i.e., cause, control/cure, consequences, identity, and, timeline). Narrative content was explored using investigator created sub-themes representing each illness representation domain. Methods: A purposive sample of prostate cancer survivors was recruited via cancer registries, word-of-mouth and newspaper advertisements in New York and Georgia from 2013 to 2014. Survivors were eligible to participate if they were diagnosed with localized prostate cancer (T1 or T2), able to speak and understand English, and self-identified as African American. Each participant completed a semi-structured, in-depth interview with a graduate trained interviewer. All men provided written informed consent and received a $50 incentive for their participation. Each interview was audiotape recorded, transcribed verbatim by a professional transcriptionist and entered into MAXQDA12 software for data management and analysis. All transcribed interviews were coded independently by a three-member team until a minimum of 80% coding agreement was reached. Results: A total of 15 men completed in-depth interviews. All interviews lasted between 30 - 90 minutes. With regard to narrative structure, survivors provided descriptions characterizing all five of the illness representation domains. More survivors provided descriptions relating to causes and consequences, while fewer provided descriptions related to the timeline domain. With regard to coping, many interviewees reported that it was challenging to simultaneously develop a treatment care plan while managing their emotions. Most descriptions of the consequences centered around concerns men had related to treatment rather than having the disease. Several interviewees expressed concerns about limitations placed on their personal and social relationships as a result of treatment complications. With regard to emotional coping, men reported a variety of adaptive and maladaptive strategies including acceptance, avoidance, humor, religion, and shared decision-making with family members and significant others. Despite these concerns, most men were grateful to be alive and were optimistic about their prognosis. Conclusion: The results of this research suggest that the CSM can be used to explain African American prostate cancer survivors' experiences with treatment care planning and coping. Future research should elucidate culturally acceptable strategies to help men simultaneously develop treatment plans and deal with the emotional aspect of having this disease. Future research should also focus on identifying similarities and differences between African American and White survivors using the CSM to determine if unique or one-size-fits all interventions are sufficient.

Citation Format: Jarrett Johnson, Sarbesh Pandeya, Ahmed Kabore, Levi Ross. Assessing the applicability of leventhal's common sense model of illness representation to explain african american prostate cancer survivors' disease experiences and disease Management Strategies. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A55.