Barriers and facilitators to access and utilisation of post-treatment psychosocial support by Black prostate cancer survivors – a systematic review


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Olufikayo Bamidele1, Obrey Alexis2, Motolani Ogunsanya3, Sarah Greenley1, Aaron Worsley2, Elizabeth Mitchell1
1University of Hull, 2Oxford Brookes University, 3Other

Abstract

Background

Evidence suggests that Black men are less likely to use posttreatment psychosocial support programmes or interventions despite their high prostate cancer risk (1 in 4) and experience of chronic treatment side-effects (e.g. sexual dysfunction). This systematic review aimed to understand the barriers and facilitators to access and utilisation of psychosocial support by Black men after treatment for prostate cancer.

Method

The systematic review was conducted using a protocol (PROSPERO registration ID: CRD42020171488). We included primary studies published in English Language and which reported data on Black men’s experiences of psychosocial support after prostate cancer treatment. Seven databases including Medline, Embase, PsychInfo, Cochrane database of Systematic Reviews and Central, CINAHL plus and Scopus were searched from inception to February 2020. Supplementary and citation searches were also conducted. Following deduplication of results, screening, quality appraisal and data extraction were undertaken by two independent reviewers. Data was analysed using thematic synthesis.

Results

3098 studies were retrieved. Following deduplication, screening and quality appraisal, ten qualitative studies published between 2004 and 2020 were included. The studies were conducted in the UK (n=5), USA (n=4) and Canada (n=1), and included 139 Black men aged 49 – 85 years old. Barriers included: men’s autonomy as influenced by masculinity/personality concerns; healthcare system, structure and process; cultural stigmatisation of masculine sexual dysfunction; and financial/physical health limitations. Facilitators included: influence of others (notably partners, peers with similar illness experience, healthcare professionals and church community); and self-motivation as influenced by men’s experience of treatment side-effects (e.g. sexual dysfunction). Conceptually expounded by the candidacy model, findings indicate an intersection between personal, cultural, structural/organisational and social factors influence Black men’s use of psychosocial support after prostate cancer treatment.

Conclusion

A collaborative approach is essential to improve uptake of developed psychosocial support by Black men after prostate cancer treatment. Such approach should incorporate the professional expertise of healthcare providers, autonomy of Black men as experts of their illness experience/support preferences and influence of social networks (specifically, partners, peers and the church community).

Impact statement

This review makes a novel contribution by addressing a critical evidence gap regarding posttreatment psychosocial support utilisation among high risk but underserved Black prostate cancer survivors.