Abstract A065: “He didn’t tell me anything” – A qualitative analysis of patient-provider communication and treatment decision-making among Latino prostate cancer patients
Authors: Rodriguez Victoria E. , Mendoza-Aguayo Briseyda , Rodriguez Janet , Ramirez Carla M. , Soto Daniel , Unger Jennifer B. , Nabhani Jamal , Abreu Andre Luis , Ariani Rojine , Baezconde-Garbanati Lourdes , Ballas Leslie , Stern Mariana C. 
Published: December 2023

Abstract
BACKGROUND: Prostate cancer is the second most diagnosed cancer among Latino men in the United States. There are disparities in prostate cancer patterns of care and adherence to active surveillance among Latino men. However, little is known about the reasons for these disparities, including patient-provider communication, knowledge, attitudes, and beliefs. PURPOSE: This single institution study explored how patient-provider communication influences treatment decision-making for Latino patients and show how these experiences might contribute to knowledge and beliefs about prostate cancer and prostate cancer treatment. METHODS: We conducted semi-structured focus groups and individual interviews in Spanish or English with 26 Latino prostate cancer patients, lasting between 30 – 60 minutes from July 2021 to October 2022. Patients were men recently diagnosed with prostate cancer in Urology clinics at the USC Norris Comprehensive Cancer Center and Los Angeles General Medical Center. Interviews were audio-recorded, transcribed, translated, and uploaded into Dedoose software for analysis. Using thematic analysis, two independent coders analyzed the interview transcripts utilizing both deductive and inductive approaches. RESULTS: Participants included 26 Latino prostate cancer patients aged 53 to 85 years old (mean = 65.3; SD = 8.42), 65% were monolingual Spanish speakers. Patients described the interactions they had with their physicians at the time of diagnosis and the role that these providers played in their decision-making for prostate cancer treatment. A large proportion of patients described negative experiences during the diagnosis and treatment of their prostate cancer, such as the physician “not explaining anything”, “not telling them anything”, or having “crude” tones. Patients who experienced these negative patient-provider relationships often reported poor communication, mistrust of their provider, and subsequently had limited knowledge about their prostate cancer and treatment. On the other hand, patients who described a shared decision-making process with their provider shared that this resulted in increased knowledge of prostate cancer and treatment. Moreover, patients who described a positive patient-provider relationship stated this resulted in having full confidence and trust in their provider’s treatment decision and/or recommendation. CONCLUSIONS: Themes of patient-provider relationships, decision-making, and knowledge of prostate cancer identified in this study support possible mechanisms that may contribute to disparities in treatment patterns and adherence to active surveillance among Latino men. Our results indicate that positive patient-provider relationships shape shared treatment decision-making and knowledge about prostate cancer and prostate cancer treatment for Latino men. Thus, healthcare providers and staff should ensure culturally competent and patient-centered communication and care to support the knowledge and outcomes of prostate cancer among Latino men.
Citation Format: Victoria E. Rodriguez, Briseyda Mendoza-Aguayo, Janet Rodriguez, Carla M. Ramirez, Daniel Soto, Jennifer B. Unger, Jamal Nabhani, Andre Luis Abreu, Rojine Ariani, Lourdes Baezconde-Garbanati, Leslie Ballas, Mariana C. Stern. “He didn’t tell me anything” – A qualitative analysis of patient-provider communication and treatment decision-making among Latino prostate cancer patients [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A065.