Abstract B144: Conceptual framework on health behaviors and experiences of Sub-Saharan African immigrant prostate cancer survivors
Authors: Kaninjing Ernie , Asiedu Gladys , Van Voorhis Kaitlin , Lee Daniel , Hinson Rakinya , Young Mary Ellen 
Published: September 2024

Abstract
Background: Sub-Saharan African immigrants (SSAI) in the United States (US) constitute one of the fastest-growing segments of the immigrant population. Between 2010 and 2018, the SSAI population in the US increased by 53%, significantly outpacing the 12% growth rate for the overall foreign-born population in the US during that period. We define SSAI as the 2 million individuals living in the US originally from the region of the African continent located south of the Saharan desert. Despite their growing numbers, little is published about the extent to which SSAI adapt to health behaviors more common in the US or remain immersed in the values, beliefs, and practices reflective of their country of origin. Importantly, no study has comprehensively examined the social determinants of health factors among this population and its influence on health-seeking behaviors and decision-making regarding prostate cancer care and treatment. Aim: This study seeks to better understand the lived experiences, unmet needs and the impact of migration on the quality of life of SSAI cancer survivors in the US. Methods. We employ a qualitative approach guided by grounded theory. Selective sampling was used to identify potential participants from a database obtained via the Florida and Minesota cancer registries. We proceeded to conduct in-depth interviews with 16 cancer survivors recruited from the two caner registries. Results. We developed a conceptual framework illuminating the full range of social, behavioral, environmental, and structural factors associated with the experiences of SSAI prostate cancer survivors. From the data, the post diagnosis experiences of study participants can be categorized into three domains: 1) health behaviors; 2) treatment decision and antecedents; 3) challenges of being an immigrant. Characteristics of health behaviors include using informal care teams for social support and second opinions before treatment. Selective disclosure of diagnosis, changes to diet, exercise and searching for information about the diseases were other manifestation of behavior. While some participants made decisions about treatment soon after diagnosis, others took a more deliberative approach and relied on faith and family for social support. Some challenges in terms of being an immigrant include knowledge gaps about the US health system, lack of health insurance and transportation to hospital during treatment. Implication for public health practice. Some of the unmet needs of study participants include transportation cost to and from hospital for radiotherapy and other treatment and reducing the high out of pocket cost for co-payment and drugs. The knowledge deficit about navigating the US health system can be addressed through community-based intervention in partnerships with immigrant groups, advocacy organizations and faith-based organizations. The focus of this intervention should be to educate and empower SSAI men on how to navigate the US health system and be more assertive about their health needs and desires for treatment during doctor’s visit.
Citation Format: Ernie Kaninjing, Gladys Asiedu, Kaitlin Van Voorhis, Daniel Lee, Rakinya Hinson, Mary Ellen Young. Conceptual framework on health behaviors and experiences of Sub-Saharan African immigrant prostate cancer survivors [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 B144.