PROSTATE CANCER EDUCATIONAL INTERVENTION AS A STRATEGY FOR ENHANCING KNOWLEDGE AND SCREENING UPTAKE OF MEN IN SELECTED HOSPITALS IN CROSS RIVER STATE, NIGERIA

Abstract

Prostate Cancer (PC) is a common cause of cancer-related death among men. In developing countries, available evidence indicates that factors responsible for high PC-related mortality rate include poor knowledge and low uptake of screening practices. In Nigeria, there is paucity of literature on PC-specific health promotion package that emphasise knowledge and screening uptake of men. This study, therefore, was designed to evaluate prostate cancer educational intervention as a strategy for enhancing knowledge and screening uptake of men in selected hospitals in Cross River State, Nigeria. A mixed method research comprising of focus group discussion and a quasi-experimental pretest-posttest research design was used. The study was conducted in four randomly selected General hospitals in three senatorial districts in Cross River State. The hospitals in Ogoja and Ugep were purposively designated Intervention Group (IG) while Akamkpa and Calabar constituted the Control Group (CG). A sample of 420 men out of 980 regular Out Patient Department attendees was proportionately distributed 210 to IG and CG respectively. An educational training package on knowledge and screening uptake of PC with four teaching sessions of 60 minutes each was administered weekly to participants in IG while CG received the traditional health education on wide range of health promotion and disease prevention activities. A validated structured questionnaire (r = 0.89) was used to assess knowledge and PC screening uptake of men at baseline (PT1), immediate post intervention (PT2), at three months (PT3) and six months post intervention (PT4) periods. The participants’ knowledge was scored on a scale of 1-100 and then categorised into good (60 - 100%), fair (40 -59%) and poor (0 - 39%). The PC screening uptake was assessed using questionnaire and authenticated by Prostate Specific Antigen assay and Digital Rectal Examination. The participants were then categorised as users and non-users. Data were analysed using descriptive statistics, student t-test, and Cochran Q test at α 0.05. Mean age of IG and CG was (51.4 ± 8.9) and (54.1 ± 8.2) years respectively. At baseline, there was a significant difference between knowledge scores of IG (10.1 ±3.0) and CG (9.1 ± 4.8). In the IG, there was an increase in knowledge scores to 19.4 ± 2.0 at PT2, 16.6 ± 2.7 at PT3 and 17 ±2.7 at PT4. Similarly, the knowledge scores increased slightly in CG to 9.8 ± 3.6 at PT2, 11.3 ± 2.1 at PT3 and decreased to 10.7 ± 2.3 at PT4. The observed increment in knowledge scores was significantly higher among IG than CG. At baseline only 2.4% of participants had utilized PC screening uptake, 5.2% at PT2, 10.5% at PT3 and 45.2% at PT4 among IG. Likewise among the CG, only 2.9% of participants had utilized PC screening uptake at baseline and at PT2, 5.4% at PT3 and at 8.1% at PT4. The observed increment in utilisation of PC screening uptake was significantly higher among IG than CG.

The Prostate cancer specific educational intervention improved the knowledge of men about prostate cancer and enhanced uptake of prostate cancer screening. It is therefore recommended for routine use in susceptible men.