Prostate cancer is the most diagnosed cancer in African American men and the
second-leading cause of cancer-related death. Disparities in prostate cancer for African
American men have persisted for almost half a century, and these health disparities are
among the most extreme of all cancers in the United States. The prostate-specific antigen
(PSA) test is an early detection screening measure for prostate cancer. Greater PSA
uptake among African Americans may reduce the disproportionate mortality burden of this
disease. However, knowledge about prostate cancer and uptake of PSA screening remain low
among African American men. The process of informed and effective decision-making is
heavily underpinned by adequate knowledge levels of the disease and screening benefits
and risks, with lower knowledge levels reported among African American men. This project
will test the feasibility of a first-of-its-kind Prostate Cancer Genius App (herein
referred to as Genius App) to improve knowledge of prostate cancer risk and symptoms. PSA
testing is not appropriate for all men, so the Genius App will support informed
decision-making with a healthcare provider. The Genius App will also provide novel
tailored navigation to complete a home-based PSA test for men who opt to screen. To test
the app, 80 African American men from Oklahoma (aged 55 and 69) who are not up to date
with PSA screening will be randomly assigned 1:1 to use either the Genius app or an
existing U.S. Department of Health & Human Services app (herein referred to as the
Prevention Taskforce App) for 30 days.
Aim 1. Evaluate the preliminary efficacy of a prostate cancer prevention app on prostate
cancer knowledge (primary outcome).
Hypothesis: Participants (n = 40) randomly assigned to the Genius app will report
significantly greater knowledge about prostate cancer post-intervention than participants
(n = 40) randomly assigned to the Prevention Taskforce app at 30 days
post-randomization.
Aim 2. Explore the perceived engagement, accessibility, and acceptability of a prostate
cancer prevention app.
The investigative team will explore: (i) the extent to which participants find the Genius
App engaging and accessible compared to the Prevention Taskforce app via validated
self-report questionnaires and app metadata; and (ii) the perceived acceptability of the
Genius App by conducting semi-structured interviews (n=40) with participants to acquire
in-depth descriptions of their experiences with the app at the end of the study.
Aim 3. Derive preliminary estimates of the effects of a Genius App on PSA screening test
completion rates and identify mechanisms of screening adherence.
The investigative team will (i) explore differences in PSA test completion rates,
including in-clinic and home-based PSA testing, between the Genius app and the Prevention
Taskforce app and (ii) identify whether changes in key variables in weekly smartphone
assessments predict completing a PSA test.