Abstract B034: Understanding how family dynamics influence discussions about prostate cancer: A PEN-3 model analysis of shared risk communication within African American families
Authors: Ross Levi , Preston Michael A. , Collins Linda , Uzoaru Florida , Lee Torhonda C. 
Published: September 2024

Background: Race and family history are important risk-stratifying variables for prostate cancer prevention and control. Despite their elevated risks for developing and dying from the disease, African-Americans are less knowledgeable about their shared familial risk than the general population. African American family structures are quite diverse. However, the manner in which this diversity influences the flow of shared risk information is largely absent from the literature. This study uses the PEN-3 cultural model to investigate how family dynamics influence prostate cancer information sharing within African American families. Method: Twenty-three members of ten families with African-American men completed semi-structured interviews in 2018 - 2019. Using a non-probability sampling scheme, nuclear, blended, extended, single-parent and cohabiting families were recruited to participate. The interview guide was structured to elicit information about participant's (a) family descriptions/family dynamics, (b) health communication patterns, (c) motivations for sharing health information, (d) health communication approaches, (e) handling of withheld information, and (f) generational communication strategies. All audio-recorded interviews were conducted by three African- American investigators and transcribed verbatim by a professional transcriptionist. All verbatim transcripts were entered into MAXQDA qualitative software for analysis using the PEN-3 model dimensions. Results: Cultural Identity - Personal/Extended: Families were more supportive of sharing sensitive health information with kinship group members who are viewed as close than distant. Neighborhood: The church family was sometimes viewed as an extension of the immediate family, particularly in situations where family members are geographically dispersed. Relationships and Expectations - Perceptions: Indirect communication is acceptable for relaying general information with young people, but direct communication is preferred for older adults. Cultural Empowerment - Negative: Withholding information to protect other's emotions can sometimes result in feelings of exclusion or mistrust when those being protected discover that information was withheld. Conclusion/Discussion: These findings highlight the complexity of family dynamics in communicating shared prostate cancer risk information within African American families. The generational divide in communication preferences suggests that strategies are needed to bridge that gap.

Citation Format: Levi Ross, Michael A. Preston, Linda Collins, Florida Uzoaru, Torhonda C. Lee. Understanding how family dynamics influence discussions about prostate cancer: A PEN-3 model analysis of shared risk communication within African American families [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B034.